Mack Karin A, Zhang Kun, Paulozzi Leonard, Jones Christopher
J Health Care Poor Underserved. 2015 Feb;26(1):182-98. doi: 10.1353/hpu.2015.0009.
Recent state-based studies have shown an increased risk of opioid overdose death in Medicaid populations. To explore one side of risk, this study examines indicators of potential opioid inappropriate use or prescribing among Medicaid enrollees. We examined claims from enrollees aged 18-64 years in the 2010 Truven Health MarketScan® Multi-State Medicaid database, which consisted of weighted and nationally representative data from 12 states. Pharmaceutical claims were used to identify enrollees (n=359,368) with opioid prescriptions. Indicators of potential inappropriate use or prescribing included overlapping opioid prescriptions, overlapping opioid and benzodiazepine prescriptions, long acting/extended release opioids for acute pain, and high daily doses. In 2010, Medicaid enrollees with opioid prescriptions obtained an average 6.3 opioid prescriptions, and 40% had at least one indicator of potential inappropriate use or prescribing. These indicators have been linked to opioid-related adverse health outcomes, and methods exist to detect and deter inappropriate use and prescribing of opioids.
近期基于州的研究表明，医疗补助人群中阿片类药物过量致死风险有所增加。为探究风险的一个方面，本研究考察了医疗补助参保者中潜在阿片类药物不当使用或处方开具的指标。我们研究了2010年Truven Health MarketScan®多州医疗补助数据库中18至64岁参保者的理赔申请，该数据库包含来自12个州的加权且具有全国代表性的数据。利用药品理赔申请来识别开具阿片类药物处方的参保者（n = 359,368）。潜在不当使用或处方开具的指标包括阿片类药物处方重叠、阿片类药物与苯二氮䓬类药物处方重叠、用于急性疼痛的长效/缓释阿片类药物以及每日高剂量。2010年，开具阿片类药物处方的医疗补助参保者平均获得6.3张阿片类药物处方，40%的人至少有一项潜在不当使用或处方开具的指标。这些指标与阿片类药物相关的不良健康后果有关，并且存在检测和阻止阿片类药物不当使用及处方开具的方法。
