Trends in Opioid Use and Prescribing in Medicare, 2006-2012
Trends in Opioid Use and Prescribing in Medicare, 2006-2012
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DOI：
10.1111/1475-6773.12846
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发表时间：
2018-10-01
影响因子：
3.4
通讯作者：
Axeen, Sarah
中科院分区：
文献类型：
--
作者：
Axeen, Sarah
客观的。确定 Medicare.Study 环境中阿片类药物使用、可疑使用和处方的特征和趋势。 2006 年至 2012 年期间，通过 Medicare D 部分为受益人提供阿片类药物处方，受益人享有全年按服务收费的 Medicare 承保范围。研究设计。对 20% 的医疗保险索赔数据样本进行回顾性分析。使用多变量回归分析调整估计值。数据收集。阿片类药物的使用、阿片类药物滥用、可疑的阿片类药物使用以及专业阿片类药物处方。主要发现。 2006 年至 2012 年期间，医疗保险中阿片类药物的平均使用情况保持稳定。每年有超过三分之一的受益人服用阿片类药物处方；大约十分之一是长期阿片类药物使用者。阿片类药物使用者的分布转向通常与慢性疼痛相关的诊断。从 2006 年到 2010 年，阿片类药物使用者滥用阿片类药物或表现出可疑使用模式的可能性越来越大，随后几年有所放缓。随着阿片类药物使用分布在分析期间的扩大，平均结果掩盖了显着变化。处方数量和强度因专业而异。数量增幅最大的是执业护士和医师助理。结论。从 2006 年到 2012 年，阿片类药物的使用和处方越来越多样化。未来的研究应侧重于解释使用和处方的差异趋势。
Objective. To determine characteristics and trends in opioid use, questionable use, and prescribing in Medicare.Study Setting. Opioid prescriptions filled through Medicare Part D for beneficiaries with full-year, fee-for-service Medicare coverage during 2006 to 2012.Study Design. Retrospective analysis of a 20 percent sample of Medicare claims data. Estimates are adjusted using multivariable regression analysis.Data Collection. Opioid use, opioid abuse, questionable opioid use, and opioid prescribing by specialty.Principal Findings. Opioid use in Medicare was stable from 2006 to 2012 on average. More than 1 in 3 beneficiaries filled an opioid prescription annually; about 1 in 10 were chronic opioid users. The distribution of opioid users shifted in favor of diagnoses often associated with chronic pain. Opioid users were increasingly likely to abuse opioids or display patterns of questionable use from 2006 to 2010, with a slowdown in later years. Average outcomes mask significant variation as the distribution of opioid use widened over the analysis period. Prescribing quantity and intensity varied by specialty. The largest quantity increases were among nurse practitioners and physician assistants.Conclusions. Opioid utilization and prescribing are increasingly heterogeneous from 2006 to 2012. Future research should focus on explaining differential trends in utilization and prescribing.