Primary care providers’ prescribing practices of opioid controlled substances

Lisa B. E. Shields, MD; Soraya Nasraty, MD, MMM, CPE; Alisha D. Bell, MSN, RN, CPN; Anil N. Vinayakan, MD; Raghunath S. Gudibanda, MD; Steven T. Hester, MD, MBA; Joshua T. Honaker, MD, FAAP

doi:10.5055/jom.2016.0359

Authors

Lisa B. E. Shields, MD
Soraya Nasraty, MD, MMM, CPE
Alisha D. Bell, MSN, RN, CPN
Anil N. Vinayakan, MD
Raghunath S. Gudibanda, MD
Steven T. Hester, MD, MBA
Joshua T. Honaker, MD, FAAP

DOI:

https://doi.org/10.5055/jom.2016.0359

Keywords:

opioids, prescription drugs, prescribing practices, pain medications, drug abuse, pain management physicians, primary care providers, anesthesiologists, addiction, diversion

Abstract

Objective: Prescription opioid abuse poses a significant public health concern. House Bill 1 (HB1) was enacted in 2012 to address prescription drug abuse in Kentucky. The authors investigated the impact of HB1 on primary care providers’ (PCPs) prescribing practices of Schedule II controlled substances.

Design: Retrospective evaluation of PCPs’ prescribing practices in an adult outpatient setting.

Methods: A review of the prescribing practices for Schedule II controlled substances written by 149 PCPs. The number of prescriptions for Schedule II controlled substances written by 149 PCPs was compared to the top 10 PCP prescribers. Attention was focused on providers who wrote for oxycontin and/or opana and prescriptions with > 90 pills dispensed.

Results: The top 10 PCP prescribers accounted for 38.4 percent of the Schedule II controlled substances and 47.8 percent of the Schedule II controlled substances with > 90 pills dispensed. Of the 60 PCPs who prescribed opana and/or oxycontin, the average number of prescriptions was 14.7 compared to 51.0 for the top 10 PCP prescribers. The average percentage of Schedule II controlled substance prescriptions compared to the total number of prescriptions was 27.9 percent for the top 10 PCP prescribers and 7.05 percent of all PCPs. The average percentage of office visits with Schedule II controlled substance prescriptions compared to total office visits was 24.8 percent for the top 10 PCP prescribers versus 7.7 percent for all PCPs.

Conclusions: Further scrutiny is warranted to more closely analyze provider opioid prescribing habits and ensure that the providers at our Institution are prescribing Schedule II controlled substances in compliance with HB1.

Author Biographies

Lisa B. E. Shields, MD

Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky

Soraya Nasraty, MD, MMM, CPE

Norton Medical Group, Norton Healthcare, Louisville, Kentucky.

Alisha D. Bell, MSN, RN, CPN

Norton Medical Group, Norton Healthcare, Louisville, Kentucky.

Anil N. Vinayakan, MD

Pain Management Associates, Norton Healthcare, Louisville, Kentucky

Raghunath S. Gudibanda, MD

Pain Management Associates, Norton Healthcare, Louisville, Kentucky.

Steven T. Hester, MD, MBA

Norton Medical Group, Norton Healthcare, Louisville, Kentucky

Joshua T. Honaker, MD, FAAP

Norton Medical Group, Norton Healthcare, Louisville, Kentucky

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