Smirnoff Anastasia, Rengifo Santiago, Spracklen Henley, Ilyas Erum N
Dermatology, Drexel University College of Medicine, Philadelphia, USA.
Foundation for Opioid Research and Education, Rothman Orthopaedic Institute, Philadelphia, USA.
Cureus. 2024 Nov 25;16(11):e74425. doi: 10.7759/cureus.74425. eCollection 2024 Nov.
Introduction The opioid epidemic is a critical public health crisis, with opioid overdose deaths being a leading cause of injury-related deaths in the United States. Dermatology, though a small contributor to overall opioid prescriptions, still accounts for over 700,000 opioid pills annually. Reducing opioid prescribing in this specialty has been challenging due to limited comprehensive research. This study aimed to investigate opioid-prescribing trends in dermatology across all nine US regions over seven years. Methods Data on opioid prescriptions by dermatologists from 2014 to 2020 were collected retrospectively from the Medicare Part D Prescribers by Provider database, available through the United States Centers for Medicare and Medicaid Services (CMS). The data were analyzed nationally and by geographic division, using US census population estimates for the respective states to calculate rates per population. Over the years studied, opioid prescription claims, the number of dermatologists, and the proportion of dermatologists prescribing opioids gradually decreased both by average and by population. Results Over the years evaluated, there were a total of 618,714 claims for short-acting opioids throughout the United States. Prescription claims, the number of dermatologists, and the proportion of dermatologists prescribing opioids all saw a gradual decrease in numbers by average and by population. Claims per year decreased from 2,023 in 2014 to 1,124 in 2020. Dermatologists per 10,000 people decreased from 0.35 in 2014 and 2015 to 0.32 in 2020. The percentage of dermatologists prescribing opioids decreased from 16.5% (0.06 per 10,000 people) in 2014 to 9.14% (0.03 per 10,000 people) in 2020. Over the seven-year period, the geographic state divisions that make up the south region had the most claims by population with 3330 claims in division 5 (3.9 per 10,000 people), 2531 claims in division 6 (5.2 per 10,000 people), and 3287 claims in division 7 (2.97 claims per 10,000 people). Division 1 had the least amount, with 0.6 claims per 10,000 people. Conclusion The findings show a gradual decline in opioid prescriptions by dermatologists, consistent with the national trend. Moreover, there are significant regional variations in opioid prescribing, with the southern states having the highest prescribing rates. The study highlights the need for targeted education policies to address regional variations and promote standardized opioid protocols in dermatology practice.
引言 阿片类药物流行是一场严重的公共卫生危机，在美国，阿片类药物过量死亡是与伤害相关死亡的主要原因。皮肤科虽然在阿片类药物总体处方中占比小，但每年仍开具超过70万片阿片类药物。由于全面研究有限，减少该专业的阿片类药物处方具有挑战性。本研究旨在调查美国九个地区七年来皮肤科的阿片类药物处方趋势。
方法 2014年至2020年皮肤科医生开具阿片类药物处方的数据是从医疗保险D部分处方者按提供者数据库中回顾性收集的，该数据库可通过美国医疗保险和医疗补助服务中心（CMS）获取。数据在全国范围内和按地理区域进行分析，使用各州的美国人口普查人口估计数来计算每人口的比率。在研究的这些年里，阿片类药物处方申请、皮肤科医生数量以及开具阿片类药物的皮肤科医生比例按平均值和按人口计算都逐渐下降。
结果 在评估的这些年里，美国各地共有618,714份短效阿片类药物的申请。处方申请、皮肤科医生数量以及开具阿片类药物的皮肤科医生比例按平均值和按人口计算数量都逐渐下降。每年的申请从2014年的2,023份降至2020年的1,124份。每10,000人中的皮肤科医生从2014年和2015年的0.35人降至2020年的0.32人。开具阿片类药物的皮肤科医生比例从2014年的16.5%（每10,000人中有0.06人）降至2020年的9.14%（每10,000人中有0.03人）。在这七年期间，构成南部地区的地理州分区按人口计算申请最多，第5分区有3330份申请（每10,000人中有3.9份），第6分区有2531份申请（每10,000人中有5.2份），第7分区有3287份申请（每10,000人中有2.97份）。第1分区最少，每10,000人中有0.6份申请。
结论 研究结果表明皮肤科医生开具的阿片类药物处方逐渐减少，与全国趋势一致。此外，阿片类药物处方存在显著的地区差异，南部各州的处方率最高。该研究强调需要有针对性的教育政策来解决地区差异，并在皮肤科实践中推广标准化的阿片类药物使用方案。
