TABLE 2.
Meta-analytic Comparison of MME Definitional Variants
| Relative Proportion More “High Dose” Patients in Florida (vs. California) | |
|---|---|
| More “High Dose” Patients, % (95% CI) | |
| Daily MME definition variant (n=3,916,461) | |
| Total days supply | 64.0 (62.5-65.5) |
| On-therapy days | 59.2 (58.0-60.3) |
| Fixed observation window | 84.3 (82.7-86.0) |
| Maximum daily dose | 38.7 (37.9-39.4) |
| I 2=99.91% | |
| Test of heterogeneity: χ2=3257, 3 df, P<0.0001 | |
| Mean difference in daily MME in Florida (vs. California) | |
| Difference in MME (95% CI) | |
| Immediate-release only (n=3,611,856) (mg) | |
| Total days supply | 3.7 (3.3-4.1) |
| On-therapy days | 3.5 (3.1-3.9) |
| Fixed observation window | 2.2 (2.2-2.3) |
| Maximum daily dose | 5.1 (4.6-5.6) |
| I 2=98.63% | |
| Test of heterogeneity: χ2=219, 3 df, P<0.0001 | |
| Extended-release only (n=66,077) (mg) | |
| Total days supply | −3.3 (−1.8 to −4.8) |
| On-therapy days | −6.8 (−4.9 to −8.7) |
| Fixed observation window | −5.9 (−4.4 to −7.4) |
| Maximum daily dose | −10.6 (−7.7 to −13.6) |
| I 2=86.38% | |
| Test of heterogeneity: χ2=22, 3 df, P=0.0001 | |
| Both extended-release and immediate-release (n=238,528) (mg) | |
| Total days supply | 8.8 (8.3-9.3) |
| On-therapy days | 16.7 (15.0-17.3) |
| Fixed observation window | 10.4 (9.2-11.5) |
| Maximum daily dose | 17.2 (15.1-19.3) |
| I 2=98.34% | |
| Test of heterogeneity: χ2=181, 3 df, P<0.0001 | |
CI indicates confidence interval; MME, milligrams of morphine equivalents.