Table 4.
Prescription Trends Studies
| Author, Year | Prescription Pattern Outcome Measure(s) | Prescription Rates | Patient Demographics | Prescriber Demographics/Prescription Filling and Trends |
|---|---|---|---|---|
| Baldasare, 2011,22 Brief Report/White Paper | Opioid prescription rates | Methadone prescriptions=933% increase Oxycodone prescriptions=588% increase Hydrocodone prescriptions=198% increase |
NR | NR |
| Volkow et al, 201111 | Physician specialty, patient age, duration of prescription, and whether the patient had filled a prior prescription | 79.5 million prescriptions for opioid analgesics (2009). Most prescriptions were for hydrocodone- and oxycodone-containing products (84.9%, 67.5 million) and issued for short treatment courses (19.1% for <2 weeks, 65.4% for 2–3 weeks). |
The percentage of prescriptions dispensed increased with age: • 0–9 years=0.7% • 10–29 years=11.7% • 40–59 years=45.7% • ≥60 years=28.3% |
• Primary care physicians=28.8% (22.9 million) of total prescriptions • Internists (14.6%, 11.6 million) • Dentists (8.0%, 6.4 million) • Orthopedic surgeons (7.7%, 6.1 million) 56.4% (44.8 million) of opioid prescriptions were dispensed to patients who had already filled another opioid prescription within the past month. |
| White et al, 201121 | Number of prescriptions filled | Prescription drug use, % with ≥1 claim • Any prescription opioid: Privately insured=66.3/controls=20.1; Florida Medicaid=74.2/controls=30.2 • Any SAO: Privately insured=64.8 / controls=20.1; Florida Medicaid=72.2 / controls=29.7 • Any LAO: Privately insured=24.4/controls=0.9; Florida Medicaid=32.7/controls=3.6 Both SAO and LAO: Privately insured=22.9/controls=0.9; Florida Medicaid=30.7/controls=3.1 |
NR | Prescription opioids, number filled – Mean (SD) Privately insured: • Opioid abuse patients (n=4474)=9.5 (13.4) ∘ LAOs=2.1 (5.1); SAOs=7.4 (11.0) • Controls (n=4474)=0.6 (2.8) ∘ LAOs=0.1 (0.9); SAOs=0.6 (2.4) Florida Medicaid: • Opioid abuse patients (n=4667)=10.0 (11.2) ∘ LAOs=2.6 (5.1); SAOs=7.5 (8.8) • Controls (n=4667)=2.1 (5.3) ∘ LAOs=0.3 (1.8); SAOs=1.8 (4.5) |
| Braker et al, 200925 | Number of prescriptions and prescribers | Prescriptions for opioids ranged from 3–28/patient; mean of 8.4 (SD=5.5) >6 prescriptions=64% patients |
NR | Number of prescribers ranged from 2–10; mean of 3.7 (SD=1.8) • Number of providers was positively correlated with prescription number (β=1.16, r2=0.15, P=0.002) 2 patients had ≥4 different types of opioid medications but had on average 7.5 providers (P=0.04). |
| GAO, 200927 (Testimonial) | Medicaid claims paid in fiscal years 2006 and 2007 | NR | NR | Approximately 65,000 Medicaid beneficiaries visited ≥6 doctors to acquire prescriptions for the same type of controlled substances (2006 and 2007). At least 400 beneficiaries visited 21–112 medical practitioners and up to 46 different pharmacies for the same controlled substance. |
| Wesiner et al, 200913 | Opioid use episodes, long-term opioid episodes, medication use profiles | KPNC prescription rates increased from 44.1% to 51.1%; GH prescription rates increased from 15.7% to 52.4%. |
Long-term opioid users with a prior substance abuse diagnosis received higher dosage levels, were more likely to use Schedule II and LAOs, and were more often frequent users of sedative-hypnotic medications in addition to their opioid use. | KPNC prevalence of long-term use increased from 11.6% to 17.0% for those with substance use disorder histories and from 2.6% to 3.9% for those without; respective GH rates, increased from 7.6% to 18.6% and from 2.7% to 4.2%. |
| Franklin et al, 200516 | Opioid prescribing patterns and accidental death | The total number of paid prescriptions for Schedule II–IV opioids: ∼120,000 prescriptions annually in 1996 to ∼150,000 annually in 2002. Prescriptions for Schedule II opioids increased 2.5 times, from ∼23,000 annually in 1996 to ∼57,000 annually in 2002. As a percent of all scheduled opioids (II–IV), Schedule II prescriptions increased from 19.3% in 1996 to 37.2% in 2002. |
NR | NR |
SAOs, short-acting opioids; LAOs, long-acting opioids; NR, not reported; SD, standard deviation; GAO, Government Accountability Office; KPNC, Kaiser Permanente of Northern California; GH, Group Health Cooperative.