Opioid Prescribing in the United States Before and After the Centers for Disease Control and Prevention’s 2016 Opioid Guideline

Details

• Alternative Title:
  Ann Intern Med
• Personal Author:
  Bohnert, Amy S.B. ; Guy, Gery P. ; Losby, Jan L.
• Description:
  Background:
  
  In response to adverse outcomes from prescription opioids, the Centers for Disease Control and Prevention (CDC) released the Guideline for Prescribing Opioids for Chronic Pain in March 2016.
  
  Objective:
  
  To test the hypothesis that the CDC guideline release corresponded to declines in specific opioid prescribing practices.
  
  Design:
  
  Interrupted time series analysis of monthly prescribing measures from the IQVIA transactional data warehouse and Real-World Data Longitudinal Prescriptions population-level estimates based on retail pharmacy data. Population size was determined by U.S. Census monthly estimates.
  
  Setting:
  
  United States, 2012 to 2017.
  
  Patients:
  
  Persons prescribed opioid analgesics.
  
  Measurements:
  
  Outcomes included opioid dosage, days supplied, overlapping benzodiazepine prescriptions, and the overall rate of prescribing.
  
  Results:
  
  The rate of high-dosage prescriptions (≥90 morphine equivalent milligrams per day) was 683 per 100 000 persons in January 2012 and declined by 3.56 (95% CI, −3.79 to −3.32) per month before March 2016 and by 8.00 (CI, −8.69 to −7.31) afterward. Likewise, the percentage of patients with overlapping opioid and benzodiazepine prescriptions was 21.04% in January 2012 and declined by 0.02% (CI, −0.04% to −0.01%) per month before the CDC guideline release and by 0.08% (CI, −0.08% to −0.07%) per month afterward. The overall opioid prescribing rate was 6577 per 100 000 persons in January 2012 and declined by 23.48 (CI, −26.18 to −20.78) each month before the guideline release and by 56.74 (CI, −65.96 to −47.53) per month afterward.
  
  Limitation:
  
  No control population; inability to determine the appropriateness of opioid prescribing.
  
  Conclusion:
  
  Several opioid prescribing practices were decreasing before the CDC guideline, but the time of its release was associated with a greater decline. Guidelines may be effective in changing prescribing practices.
  
  Primary Funding Source:
  
  CDC.
  
  
• Subjects:
  Article
• Source:
  Ann Intern Med. 169(6):367-375
• Pubmed ID:
  30167651
• Pubmed Central ID:
  PMC6176709
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  169
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:776ac8bdfb2f3a4ed3740cd4c4f4bc4c66859e6919ba20ea0b853e2f79b3a755
• Download URL:
  https://stacks.cdc.gov/view/cdc/59716/cdc_59716_DS1.pdf
• File Type:
  [PDF - 769.28 KB ]