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Association between the North Carolina Medical Board opioid guideline update and opioid prescriptions in Medicare Part D beneficiaries

Chris Gillette, PhD, Mark A. Bush, PhD, Kate M. L. Rogers, PharmD Candidate, Geoffrey Mospan, PharmD, BCPS, Kimberly Nealy, PharmD, BCPS, CDE, CPP, Michelle DeGeeter, PharmD, BCACP, CDE, April M. Robinson, PharmD, BCPS


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.


pain, opioid, health services research

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