Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Department of Emergency Medicine, Swedish Medical Center, Seattle, Washington.
Pain Med. 2018 May 1;19(5):978-989. doi: 10.1093/pm/pnx027.
The current US opioid epidemic is attributed to the large volume of prescribed opioids. This study analyzed the contribution of different medical specialties to overall opioids by evaluating the pill counts and morphine milligram equivalents (MMEs) of opioid prescriptions, stratified by provider specialty, and determined temporal trends.
This was an analysis of the Ohio prescription drug monitoring program database, which captures scheduled medication prescriptions filled in the state as well as prescriber specialty. We extracted prescriptions for pill versions of opioids written in the calendar years 2010 to 2014. The main outcomes were the number of filled prescriptions, pill counts, MMEs, and extended-released opioids written by physicians in each specialty, and annual prescribing trends.
There were 56,873,719 prescriptions for the studied opioids dispensed, for which 41,959,581 (73.8%) had prescriber specialty type available. Mean number of pills per prescription and MMEs were highest for physical medicine/rehabilitation (PM&R; 91.2 pills, 1,532 mg, N = 1,680,579), anesthesiology/pain (89.3 pills, 1,484 mg, N = 3,261,449), hematology/oncology (88.2 pills, 1,534 mg, N = 516,596), and neurology (84.4 pills, 1,230 mg, N = 573,389). Family medicine (21.8%) and internal medicine (17.6%) wrote the most opioid prescriptions overall. Time trends in the average number of pills and MMEs per prescription also varied depending on specialty.
The numbers of pills and MMEs per opioid prescription vary markedly by prescriber specialty, as do trends in prescribing characteristics. Pill count and MME values define each specialty's contribution to overall opioid prescribing more accurately than the number of prescriptions alone.
当前美国阿片类药物泛滥的原因是大量开处阿片类药物。本研究通过评估按提供者专业划分的阿片类药物处方的药丸数和吗啡毫克当量（MME），分析了不同医学专业对整体阿片类药物的贡献，并确定了时间趋势。
这是对俄亥俄州处方药物监测计划数据库的分析，该数据库捕获了该州的规定药物处方以及处方医生的专业。我们提取了 2010 年至 2014 年日历年度开具的阿片类药物丸剂处方。主要结果是每个专业的医生开具的已填充分装处方数量、药丸数量、MME 和延长释放阿片类药物数量，以及年度处方趋势。
共开出了 56873719 份研究用阿片类药物处方，其中 41959581 份（73.8%）有处方医生专业类型。每处方药丸数和 MME 最高的专业是物理医学/康复（PM&R；91.2 粒，1532mg，N=1680579）、麻醉学/疼痛科（89.3 粒，1484mg，N=3261449）、血液学/肿瘤学（88.2 粒，1534mg，N=516596）和神经病学（84.4 粒，1230mg，N=573389）。家庭医学（21.8%）和内科（17.6%）开具的阿片类药物处方总数最多。每处方药丸数和 MME 的时间趋势也因专业而异。
每个阿片类药物处方的药丸数和 MME 数量因医生专业而异，处方特征的趋势也各不相同。与单独的处方数量相比，药丸数和 MME 值更能准确地定义每个专业对整体阿片类药物处方的贡献。
