Coprescribing of opioids and high-risk medications in the USA: a cross-sectional study with data from national ambulatory and emergency department settings.
BMJ Open
; 12(6): e057588, 2022 06 16.
Article
in English
| MEDLINE | ID: covidwho-1901998
ABSTRACT
OBJECTIVE:
Describe trends in opioid plus high-risk medication coprescribing in the USA.DESIGN:
Analyses of serial, cross-sectional, nationally representative data of the National Ambulatory Medical Care Survey (NAMCS) over 2007-2016 and the National Hospital Ambulatory Medical Care Survey (NHAMCS) over 2007-2018.SETTING:
US ambulatory (NAMCS) and emergency department (ED, NHAMCS) settings.PARTICIPANTS:
Patient visits in which the patient was 18 years and older with an opioid prescription in the NAMCS or NHAMCS databases. PRIMARY AND SECONDARY OUTCOMEMEASURES:
Frequency of opioid plus high-risk medication coprescribing.RESULTS:
From a combined sample of 700 499 visits over 2007-2018, there were 105 720 visits (15.1%) where opioids were prescribed. n=31 825 were from NAMCS and n=73 895 were from NHAMCS. The mean prevalence of coprescription of opioids and high-risk medications for the combined NAMCS and NHAMCS sample was 18.4% in 2007, peaked at 33.2% in 2014 and declined to 23.8% in 2016. Compared with adults receiving opioid prescriptions alone, those coprescribed opioids and high-risk medications were older, more likely female, white and using private or Medicare insurance (p<0.0001).CONCLUSIONS:
Coprescribing is more common in ambulatory than ED settings and has been declining, yet one in four patient visits where opioids were prescribed resulted in coprescribed, high-risk medications in 2016. Efforts and research to help lower the rates of high-risk prescribing are needed.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Medicare
/
Analgesics, Opioid
Type of study:
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adult
/
Aged
/
Female
/
Humans
Country/Region as subject:
North America
Language:
English
Journal:
BMJ Open
Year:
2022
Document Type:
Article
Affiliation country:
Bmjopen-2021-057588
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