Wang Shanshan, Rossheim Matthew E, Walters Scott T, Nandy Rajesh R, Northeim Kari
Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
Department of Health Administration & Health Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
Am J Drug Alcohol Abuse. 2024 Sep 2;50(5):690-702. doi: 10.1080/00952990.2024.2400916. Epub 2024 Oct 15.
Amid the national opioid epidemic, it is important to assess trends in opioid prescriptions. Long-acting opioids (LAOs) are of particular interest as they are among the most intensely misused prescription opioids. Moreover, understanding geographic trends in opioid prescriptions may help identify state-level variations, illustrating state-specific disparities. The study aims to determine geographic trends in overall and LAO prescriptions under Medicaid and Medicare Part D from 2013 to 2021. We used data from the Centers for Medicare & Medicaid Services on opioid prescriptions from 2013 to 2021. The opioid prescribing proportion was calculated as the number of opioid claims divided by the total number of overall drug claims. The LAO prescribing proportion was calculated as number of LAO claims divided by total opioid claims. Despite a general decrease nationwide, Medicaid opioid prescribing proportions increased in Iowa, Montana, and Virginia. There was an increasing trend in the national-level Medicaid LAO prescribing proportion from 2017 to 2021, with a 14.1% point increase (p for the annual percent change [APC]<0.05). For Medicare Part D, the overall prescribing proportions fell by 1.7% points from 2013 to 2021, while the LAO prescribing proportion fell by 3% points from 2016 to 2021 (p for APC < .05). The increasing trends in national-level Medicaid LAO prescribing and Medicaid opioid prescribing in Iowa, Montana, and Virginia are concerning, and have implications for clinical opioid prescribing. The decreasing trends in Medicare Part D may reflect ongoing efforts in opioid prescription management.
在美国全国性的阿片类药物流行期间，评估阿片类药物处方的趋势很重要。长效阿片类药物（LAOs）尤其值得关注，因为它们是滥用最严重的处方阿片类药物之一。此外，了解阿片类药物处方的地理趋势可能有助于识别州级差异，说明各州特有的差距。该研究旨在确定2013年至2021年医疗补助计划（Medicaid）和医疗保险D部分（Medicare Part D）下总体和长效阿片类药物处方的地理趋势。我们使用了医疗保险和医疗补助服务中心（Centers for Medicare & Medicaid Services）2013年至2021年阿片类药物处方的数据。阿片类药物处方比例的计算方法是阿片类药物索赔数量除以总体药物索赔总数。长效阿片类药物处方比例的计算方法是长效阿片类药物索赔数量除以阿片类药物索赔总数。尽管全国范围内总体呈下降趋势，但爱荷华州、蒙大拿州和弗吉尼亚州的医疗补助计划阿片类药物处方比例有所增加。2017年至2021年，全国医疗补助计划长效阿片类药物处方比例呈上升趋势，增加了14.1个百分点（年度百分比变化[APC]的p值<0.05）。对于医疗保险D部分来说，总体处方比例从2013年到2021年下降了1.7个百分点，而长效阿片类药物处方比例从2016年到2021年下降了3个百分点（APC的p值<0.05）。全国医疗补助计划长效阿片类药物处方以及爱荷华州、蒙大拿州和弗吉尼亚州医疗补助计划阿片类药物处方的上升趋势令人担忧，对临床阿片类药物处方有影响。医疗保险D部分的下降趋势可能反映了阿片类药物处方管理方面正在做出的努力。
