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Opioid prescribing rates from the emergency department: Down but not out.
Drug Alcohol Depend. 2019 12 01; 205:107636.DA

Abstract

INTRODUCTION

To examine opioid prescribing rates following emergency department (ED) discharge stratified by patient's clinical and demographic characteristics over an 11-year period.

MATERIAL AND METHODS

We used 3.9 million ED visits from commercially insured enrollees and 15.2 million ED visits from Medicaid enrollees aged 12 to 64 over 2005-2016 from the IBM® MarketScan® Research Databases. We calculated rates of opioid prescribing at discharge from the ED and the average number of pills per opioid prescription filled.

RESULTS

Approximately 15-20% of ED visits resulted in opioid prescriptions filled. Rates increased from 2005 into late 2009 and 2010 and then declined steadily through 2016. Prescribing rates were similar for commercially insured and Medicaid enrollees. Being aged 25-54 years was associated with the highest rates of opioid prescriptions being filled. Hydrocodone was the most commonly prescribed opioid, but rates for hydrocodone prescription filling also fell the most. Rates for oxycodone were stable, and rates for tramadol increased. The average number of pills dispensed from prescriptions filled remained steady over the study period at 18-20.

DISCUSSION

Opioid prescribing rates from the ED have declined steadily since 2010 in reversal of earlier trends; however, about 15% of ED patients still received opioid prescriptions in 2016 amidst a national opioid crisis.

CONCLUSIONS

Efforts to reduce opioid prescribing could consider focusing on the pain types, age groups, and regions with high prescription rates identified in this study.

Authors+Show Affiliations

Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, 200 Independence Avenue SW, Washington D.C., 20201, USA. Electronic address: ali.mir.m@gmail.com.Qventus, USA.Health, Retirement and Long-Term Analysis Division, Congressional Budget Office, USA.IBM Watson Health, USA.MedStar Washington Hospital Center, USA.US Acute Care Solutions, USA.IBM Watson Health, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31704377

Citation

Ali, Mir M., et al. "Opioid Prescribing Rates From the Emergency Department: Down but Not Out." Drug and Alcohol Dependence, vol. 205, 2019, p. 107636.
Ali MM, Cutler E, Mutter R, et al. Opioid prescribing rates from the emergency department: Down but not out. Drug Alcohol Depend. 2019;205:107636.
Ali, M. M., Cutler, E., Mutter, R., Henke, R. M., Mazer-Amirshahi, M., Pines, J. M., & Cummings, N. (2019). Opioid prescribing rates from the emergency department: Down but not out. Drug and Alcohol Dependence, 205, 107636. https://doi.org/10.1016/j.drugalcdep.2019.107636
Ali MM, et al. Opioid Prescribing Rates From the Emergency Department: Down but Not Out. Drug Alcohol Depend. 2019 12 1;205:107636. PubMed PMID: 31704377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opioid prescribing rates from the emergency department: Down but not out. AU - Ali,Mir M, AU - Cutler,Eli, AU - Mutter,Ryan, AU - Henke,Rachel Mosher, AU - Mazer-Amirshahi,Maryann, AU - Pines,Jesse M, AU - Cummings,Nicholas, Y1 - 2019/10/17/ PY - 2019/03/13/received PY - 2019/06/20/revised PY - 2019/09/17/accepted PY - 2019/11/11/pubmed PY - 2020/7/15/medline PY - 2019/11/10/entrez KW - Emergency department KW - Insurance KW - Medicaid KW - Opioids SP - 107636 EP - 107636 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 205 N2 - INTRODUCTION: To examine opioid prescribing rates following emergency department (ED) discharge stratified by patient's clinical and demographic characteristics over an 11-year period. MATERIAL AND METHODS: We used 3.9 million ED visits from commercially insured enrollees and 15.2 million ED visits from Medicaid enrollees aged 12 to 64 over 2005-2016 from the IBM® MarketScan® Research Databases. We calculated rates of opioid prescribing at discharge from the ED and the average number of pills per opioid prescription filled. RESULTS: Approximately 15-20% of ED visits resulted in opioid prescriptions filled. Rates increased from 2005 into late 2009 and 2010 and then declined steadily through 2016. Prescribing rates were similar for commercially insured and Medicaid enrollees. Being aged 25-54 years was associated with the highest rates of opioid prescriptions being filled. Hydrocodone was the most commonly prescribed opioid, but rates for hydrocodone prescription filling also fell the most. Rates for oxycodone were stable, and rates for tramadol increased. The average number of pills dispensed from prescriptions filled remained steady over the study period at 18-20. DISCUSSION: Opioid prescribing rates from the ED have declined steadily since 2010 in reversal of earlier trends; however, about 15% of ED patients still received opioid prescriptions in 2016 amidst a national opioid crisis. CONCLUSIONS: Efforts to reduce opioid prescribing could consider focusing on the pain types, age groups, and regions with high prescription rates identified in this study. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/31704377/Opioid_prescribing_rates_from_the_emergency_department:_Down_but_not_out_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(19)30413-2 DB - PRIME DP - Unbound Medicine ER -