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Opioid Prescribing in the United States Before and After the Centers for Disease Control and Prevention’s 2016 Opioid Guideline
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August 28 2018
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Source: Ann Intern Med. 169(6):367-375
Details:
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Alternative Title:Ann Intern Med
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Personal Author:
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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.
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Subjects:
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Source:
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Pubmed ID:30167651
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Pubmed Central ID:PMC6176709
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Document Type:
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Funding:
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Volume:169
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Issue:6
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