Economics Department, Darla Moore School of Business, University of South Carolina, Columbia, 803-4636168, USA.
Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina University of South Carolina, Columbia, USA.
Appl Health Econ Health Policy. 2021 May;19(3):415-428. doi: 10.1007/s40258-020-00622-4. Epub 2020 Nov 30.
There are variants of prescription drug monitoring programs (PDMPs) and different groups of patients who are prescribed opioids. Patients with disabilities and those with chronic conditions might have different experiences in physician prescribing practices for opioids, when compared to a comparison group without these conditions.
To determine differences in opioid prescriptions related to PDMPs for people without cancer-related pain and with disability conditions compared to other adult opioid users without cancer, using a national database.
Opioid users were identified from the US Medical Expenditure Panel Survey. Disability groups were defined by diagnosis codes related to longstanding physical disability and inflammatory conditions. Our analyses used an event study framework and a difference-in-differences approach.
During a two-year panel period, PDMPs did not reduce opioid prescriptions for individuals with disabilities who use opioids. Our data show that individuals with disabilities who use opioids, on average, have a higher incidence of continuous opioid use and significantly greater amounts prescribed compared to other adults who have opioid prescriptions.
PDMPs do not appear to affect prescribers' initial or ongoing use of opioids for individuals with longstanding physical disabilities and those with inflammatory conditions. Thus, these adults have greater exposure to opioids, compared to other adults who were prescribed opioids.
处方药物监测计划(PDMP)存在多种变体,不同群体的患者也会被开具阿片类药物。与没有这些疾病的对照组相比,残疾患者和患有慢性疾病的患者在医生开具阿片类药物的治疗方案方面可能会有不同的体验。
使用国家数据库,确定与 PDMP 相关的阿片类药物处方在无癌症相关疼痛且有残疾状况的人群与无癌症的其他成年阿片类药物使用者之间的差异。
从美国医疗支出调查中确定阿片类药物使用者。残疾人群由与长期身体残疾和炎症性疾病相关的诊断代码定义。我们的分析采用事件研究框架和差分差异方法。
在两年的小组期间,PDMP 并未减少使用阿片类药物的残疾个体的阿片类药物处方。我们的数据表明,与其他有阿片类药物处方的成年人相比,使用阿片类药物的残疾个体平均具有更高的持续阿片类药物使用发生率和显著更高的处方量。
PDMP 似乎不会影响长期身体残疾和患有炎症性疾病的个体的初始或持续使用阿片类药物。因此,与其他被开具阿片类药物的成年人相比,这些成年人接触阿片类药物的风险更高。