Association between the North Carolina Medical Board opioid guideline update and opioid prescriptions in Medicare Part D beneficiaries
DOI:
https://doi.org/10.5055/jom.2018.0455Keywords:
pain, opioid, health services researchAbstract
Objective: To examine if North Carolina (NC) opioid prescribing guidelines were associated with changes in opioid prescribing.
Method: Retrospective secondary analysis of the Medicare Provider Utilization and Payment Data: Part D Prescriber datasets from 2013 to 2015.
Participants: Providers who prescribed at least one opioid from 2013 to 2015 and paid by Medicare Part D.
Main outcome measure: Per-prescriber Medicare-population adjusted number of analgesic opioid claims and per-prescriber average day supply. Generalized estimating equations (GEE) were used to analyze the data.
Results: There were significantly higher per-prescriber Medicare adjusted opioid claims in 2014 compared to 2015 (p < 0.001) but no difference between 2013 and 2015 (p = 0.584). GEE results also indicated that there was a significant increase in 2015 in per-prescriber average day supply, compared to 2013 and 2014 (both p < 0.0001).
Conclusions: State opioid prescribing guidelines published in mid-2014 may have slowed the escalation of numbers of opioid prescriptions in NC. Future research should examine whether the guidelines were associated with changes in morphine equivalent dosing in NC during the same timeframe.
References
CDC: Understanding the epidemic. Centers for Disease Control and Prevention Web site. December 16, 2016. Available at https://www.cdc.gov/drugoverdose/epidemic/index.html. Accessed August 30, 2017.
Rudd RA, Seth P, David F, et al.: Increases in drug and opioid-involved overdose deaths-United States, 2010-2015. MMWR Morb Mortal Wkly Rep. 2016; 65: 1445-1452.
CDC: Injury prevention and control: Opioid overdose. Centers for Disease Control and Prevention Web site. December 20, 2016. Available at https://www.cdc.gov/drugoverdose/data/prescribing.html. Accessed August 30, 2017.
North Carolina Medical Society: NCMB adopts new policy on opioid prescribing. North Carolina Medical Society Web site. Available at http://www.ncmedsoc.org/ncmb-adopts-new-policyon-opioid-prescribing/. Accessed August 30, 2017.
Modarai F, Mack F, Hicks P, et al.: Relationship of opioid prescription sales and overdoses, North Carolina. Drug Alcohol Depend. 2013; 132(1-2): 81-86.
Centers for Medicare and Medicaid Services: Medicare provider utilization and payment data: Part D prescriber. Centers for Medicare and Medicaid Web site. May 25, 2017. Available at https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Part-D-Prescriber.html. Accessed August 30, 2017.
Kaiser Family Foundation: Total number of Medicare beneficiaries. The Kaiser Family Foundation Web site. Available at http://www.kff.org/medicare/state-indicator/total-medicare-beneficiaries/?currentTimeframe=2&selectedRows=%7B%22states%22:%7B%22north-carolina%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D. Accessed August 31, 2017.
Weiner SG, Baker O, Poon SJ, et al.: The effect of opioid prescribing guidelines on prescriptions by emergency physicians in Ohio. Ann Emerg Med. 2017; 70(6): 799-808.
Franklin GM, Mai J, Turner J, et al.: Bending the prescription opioid dosing and mortality curves: Impact of the Washington State opioid dosing guideline. Am J Ind Med. 2012; 55: 325-331.
Chen JH, Humphreys K, Shah NH, et al.: Distribution of opioids by different types of Medicare prescribers. JAMA Intern Med. 2016; 176(2): 259-261.
Published
How to Cite
Issue
Section
License
Copyright 2005-2024, Weston Medical Publishing, LLC
All Rights Reserved
