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Patterns in opioid prescription in the United States by region and prescribers over a 4-year period.
J Opioid Manag. 2019 Nov/Dec; 15(6):499-506.JO

Abstract

BACKGROUND

As determinants of the opioid epidemic are several, describing patterns of opioid prescription over time is of importance.

OBJECTIVE

To characterize the prescribing patterns of opioids per US region and physician specialty from 2012 to 2015.

METHODS

Truven Health Analytics MarketScan® Databases were used to obtain data on opioid prescription rates per US region and physician specialty for the years 2012-2015. Opioids included in the study are tramadol, hydrocodone, codeine, oxycodone, oxymorphone, methadone, and fentanyl.

RESULTS

Starting sample consisted of 5,860,096 individuals. An increase in prescriptions was seen for codeine (22.3 percent), oxycodone (22.4 percent), and tramadol (22.4 percent), while other opioids had decreases between 6.5 and 20.2 percent during this period. Family medicine physicians were the most frequent prescriber for all opioids except for oxycodone; nonphysician prescribers' share of prescriptions nearly doubled for all opioids. The share of oxycodone and of tramadol among all opioids increased in all regions, while the opposite was seen for hydrocodone. Codeine prescription share increased substantially in the South but not in other regions. When comparing the period of 2012-2015, differences were significant for all regions (p < 0.0001 for all regions). In 2015, the rate of prescription of oxycodone was nearly twofold higher in the Northeast vs North Central (38 percent vs 18.5 percent, p < 0.0001), while tramadol was substantially more frequently prescribed in the South, where it responded to nearly 20 percent of all opioid prescriptions (p < 0.0001).

CONCLUSION

Patterns of prescription per opioid vary considerably per physician specialty and per US region. Although an overall decrease in prescriptions was seen, certain opioids were more frequently prescribed in 2015 than in 2012.

Authors+Show Affiliations

Undergraduate in Global Health and International Comparative Government, Duke University, Durham, North Carolina.Head, Global Health Outcomes and Real World Evidence Generation, Incyte Pharma, Chadds Ford, Pennsylvania.Head of Clinical Operations, Biometrics and Data Sciences, Teva Pharmaceuticals, Horsham, Pennsylvania.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31850512

Citation

Bigal, Luisa M., et al. "Patterns in Opioid Prescription in the United States By Region and Prescribers Over a 4-year Period." Journal of Opioid Management, vol. 15, no. 6, 2019, pp. 499-506.
Bigal LM, Bibeau K, Dumbar S. Patterns in opioid prescription in the United States by region and prescribers over a 4-year period. J Opioid Manag. 2019;15(6):499-506.
Bigal, L. M., Bibeau, K., & Dumbar, S. (2019). Patterns in opioid prescription in the United States by region and prescribers over a 4-year period. Journal of Opioid Management, 15(6), 499-506. https://doi.org/10.5055/jom.2019.0541
Bigal LM, Bibeau K, Dumbar S. Patterns in Opioid Prescription in the United States By Region and Prescribers Over a 4-year Period. J Opioid Manag. 2019 Nov/Dec;15(6):499-506. PubMed PMID: 31850512.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns in opioid prescription in the United States by region and prescribers over a 4-year period. AU - Bigal,Luisa M, AU - Bibeau,Kristen, AU - Dumbar,Stephanie, PY - 2019/12/19/entrez PY - 2019/12/19/pubmed PY - 2020/1/8/medline SP - 499 EP - 506 JF - Journal of opioid management JO - J Opioid Manag VL - 15 IS - 6 N2 - BACKGROUND: As determinants of the opioid epidemic are several, describing patterns of opioid prescription over time is of importance. OBJECTIVE: To characterize the prescribing patterns of opioids per US region and physician specialty from 2012 to 2015. METHODS: Truven Health Analytics MarketScan® Databases were used to obtain data on opioid prescription rates per US region and physician specialty for the years 2012-2015. Opioids included in the study are tramadol, hydrocodone, codeine, oxycodone, oxymorphone, methadone, and fentanyl. RESULTS: Starting sample consisted of 5,860,096 individuals. An increase in prescriptions was seen for codeine (22.3 percent), oxycodone (22.4 percent), and tramadol (22.4 percent), while other opioids had decreases between 6.5 and 20.2 percent during this period. Family medicine physicians were the most frequent prescriber for all opioids except for oxycodone; nonphysician prescribers' share of prescriptions nearly doubled for all opioids. The share of oxycodone and of tramadol among all opioids increased in all regions, while the opposite was seen for hydrocodone. Codeine prescription share increased substantially in the South but not in other regions. When comparing the period of 2012-2015, differences were significant for all regions (p < 0.0001 for all regions). In 2015, the rate of prescription of oxycodone was nearly twofold higher in the Northeast vs North Central (38 percent vs 18.5 percent, p < 0.0001), while tramadol was substantially more frequently prescribed in the South, where it responded to nearly 20 percent of all opioid prescriptions (p < 0.0001). CONCLUSION: Patterns of prescription per opioid vary considerably per physician specialty and per US region. Although an overall decrease in prescriptions was seen, certain opioids were more frequently prescribed in 2015 than in 2012. SN - 1551-7489 UR - https://www.unboundmedicine.com/medline/citation/31850512/Patterns_in_opioid_prescription_in_the_United_States_by_region_and_prescribers_over_a_4_year_period_ DB - PRIME DP - Unbound Medicine ER -