Truven Health Analytics, An IBM Company, United States.
Substance Abuse & Mental Health Services Administration, Center for Behavioral Health Statistics & Quality, 5600 Fishers Lane, Rockville, MD 20852, United States.
Addict Behav. 2018 Jan;76:218-222. doi: 10.1016/j.addbeh.2017.08.005. Epub 2017 Aug 19.
To calculate trends in adult average days' supply for six commonly prescribed opioids: hydrocodone, hydromorphone, morphine, oxycodone, oxymorphone, and tapentadol to assess whether physicians changed prescribing practices at the time of the intensifying epidemic.
We used 2005-2015 Truven Health MarketScan Commercial Claims and Encounters data to measure trends in opioid average days' supply among commercially insured individuals and 2005-2014 MarketScan Multi-State Medicaid data to measure trends in opioid average days' supply among Medicaid beneficiaries.
For Medicaid, we found an increase in days' supply for all drugs except morphine. The largest percentage increase was for oxycodone, which increased 4.5days (37%). Opioid days' supply for individuals with commercial insurance exhibited similar but steeper trends. The largest increase was also for oxycodone, which increased 6days (56%). Between 2013 and 2015, when the opioid epidemic had begun to be widely publicized, there was no decline in the median days supplied for any of the opioids.
Our results find that days' supply of opioids are increasing despite public health campaigns and media attention on the risks of opioid prescribing. More effective interventions to curb opioid prescribing are needed to reverse these trends.
计算六种常用处方类阿片药物(氢可酮、氢吗啡酮、吗啡、羟考酮、羟吗啡酮和酒石酸布托啡诺)成人平均日供应量的趋势,以评估在疫情加剧期间医生是否改变了处方习惯。
我们使用了 2005 年至 2015 年 Truven Health MarketScan 商业索赔和就诊数据来衡量商业保险个体中阿片类药物平均日供应量的趋势,使用了 2005 年至 2014 年 MarketScan 多州医疗补助数据来衡量医疗补助受益人群中阿片类药物平均日供应量的趋势。
对于医疗补助人群,除吗啡外,所有药物的日供应量均有所增加。其中,羟考酮的增幅最大,增加了 4.5 天(37%)。商业保险个体的阿片类药物日供应量也呈现出类似但更为陡峭的趋势。增幅最大的同样是羟考酮,增加了 6 天(56%)。在阿片类药物流行开始广泛报道的 2013 年至 2015 年期间,任何一种阿片类药物的中位数日供应量都没有下降。
尽管有公共卫生宣传活动和媒体对阿片类药物处方风险的关注,但阿片类药物的日供应量仍在增加。需要采取更有效的干预措施来遏制阿片类药物的处方,以扭转这些趋势。