Department of Radiology, NYU Langone Medical Center, New York, New York.
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
J Am Coll Radiol. 2018 May;15(5):726-733. doi: 10.1016/j.jacr.2018.01.003. Epub 2018 Feb 22.
To study opioid prescribing behavior of US interventional radiologists (IRs).
Using Medicare Physician and Other Supplier Public Use File claims, we identified 2,133 radiologists whose practice in 2015 comprised predominantly interventional radiology. Cross-linking the Medicare Part D Prescriber File, their opioid prescription writing behavior was characterized.
Most (52.2%) IRs wrote 10 or fewer prescriptions total for Medicare beneficiaries. Of the 47.8% who wrote >10 prescriptions, 87.4% prescribed an opioid, most commonly hydrocodone with acetaminophen, at least once (71.3%, 1-10 opioid prescriptions; 27.4%, 11-100; 1.3%, ≥101). Overall, 23.0% of all prescriptions by those IRs writing >10 were for opioids, with an average 8.0-day prescription. Average opioid prescriptions per IR were significantly (P ≤ .015) independently associated with their providing clinical evaluation and management (E&M) services (9.7 opioid prescriptions per IR with demonstrable E&M encounters versus 2.2 if not), practice size (12.6 for practices with ≤ 10 members versus 3.7-4.8 for larger groups), and geography (8.3 in the South versus 3.6-4.0 elsewhere). Rates were highest in Georgia (39.5) and lowest in Delaware (2.0). Higher opioid prescribing rates showed additional univariable associations with more years in practice and nonacademic practices.
Most IRs write few, if any, prescriptions for Medicare beneficiaries. Of those who do, the large majority writes for opioids, at rates higher than national physician benchmarks. IRs' opioid prescribing varies significantly based on physician and practice characteristics and particularly whether the IR provides clinical E&M services. In light of the nation's opioid epidemic, these observations may guide education, practice improvement, and policy efforts to optimize opioid prescribing.
研究美国介入放射医师(IR)的阿片类药物处方行为。
使用医疗保险医师和其他供应商公共使用文件索赔,我们确定了 2133 名放射科医生,他们在 2015 年的主要实践是介入放射学。通过交叉链接医疗保险部分 D 处方医生文件,描述了他们的阿片类药物处方书写行为。
大多数(52.2%)IR 总共为医疗保险受益人开具的处方少于 10 张。在开具>10 张处方的 47.8%中,87.4%开具了阿片类药物,最常见的是氢可酮与对乙酰氨基酚,至少开具一次(71.3%,1-10 张阿片类药物处方;27.4%,11-100 张;1.3%,≥101 张)。总体而言,开具>10 张处方的所有 IR 中,23.0%的处方为阿片类药物,平均处方天数为 8.0 天。每位 IR 开具的阿片类药物处方数量与他们提供临床评估和管理(E&M)服务显著相关(有明显 E&M 就诊的 IR 开具 9.7 张阿片类药物处方,没有 E&M 就诊的 IR 开具 2.2 张),与实践规模(10 名以下成员的实践开具 12.6 张阿片类药物处方,较大团体的处方为 3.7-4.8 张)和地理位置(南部开具 8.3 张阿片类药物处方,其他地区开具 3.6-4.0 张)显著相关。佐治亚州的处方率最高(39.5%),特拉华州最低(2.0%)。较高的阿片类药物处方率与更多的行医年限和非学术实践有进一步的单变量关联。
大多数 IR 为医疗保险受益人开具的处方很少,如果有的话。其中,绝大多数开具阿片类药物处方,其开具率高于全国医生基准。IR 的阿片类药物处方开具情况因医生和实践特征而有很大差异,尤其是 IR 是否提供临床 E&M 服务。鉴于全国阿片类药物流行,这些观察结果可能为优化阿片类药物处方提供教育、实践改进和政策方面的指导。