Broadband internet subscription rates and opioid prescribing via telemedicine during the COVID-19 pandemic.
Broadband internet subscription rates and opioid prescribing via telemedicine during the COVID-19 pandemic.
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COVID-19 大流行期间的宽带互联网订阅率和通过远程医疗开出的阿片类药物处方。
DOI：
10.1111/jrh.12653
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Westgate,PhilipM
中科院分区：
文献类型：
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作者：
Oyler,DouglasR;Slavova,Svetla;Freeman,PatriciaR;Huang,Zhengyan;Talbert,Jeffery;Walsh,SharonL;Westgate,PhilipM
目的为了应对 COVID-19 大流行，美国 DEA 允许在远程医疗后开具受控药物处方。本研究评估了肯塔基州宽带订阅率低和高的县在一系列可能影响医疗保健获取的全州紧急声明之前、期间和之后阿片类药物处方的变化。方法该研究使用处方药监测计划来分析在紧急状态之前的 3 个时期内向高宽带接入县 (N = 26) 和低宽带接入县 (N = 94) 的未使用过阿片类药物的个体发放阿片类止痛药处方的记录(SOE) 和行政命令 (EO) 限制非紧急医疗保健服务（2019 年 1 月至 2020 年 2 月）、行政命令生效期间（2020 年 3 月至 4 月）以及医疗保健服务开始重新开放后（2020 年 5 月至 2020 年 12 月）。边际广义估计方程型负二项式模型适合比较 3 个时期内宽带接入的处方数量。研究结果在 EO 期间，向未使用过阿片类药物的个体发放阿片类药物的比例显着下降，但在医疗保健服务开始重新开放后几乎增加到 SOE 之前的水平。在所有时间段内，低宽带县的配药率均高于高宽带县的配药率，尽管在调整潜在的混杂因素后，这些差异可以忽略不计。在行政命令期间，两种县类型的处方均针对更长天数的供应而开出。 结论 在评估年度阿片类药物处方趋势时，应考虑阿片类药物处方率的总体大幅下降。然而，宽带订阅率似乎并未影响行政命令期间肯塔基州发放的阿片类药物处方。
PurposeIn response to the COVID‐19 pandemic, the US DEA allowed controlled substance prescriptions to be issued following a telemedicine encounter. This study evaluated changes in opioid prescribing in Kentucky counties with low and high rates of broadband subscription before, during, and after a series of statewide emergency declarations that may have affected health care access.MethodsThe study used the prescription drug monitoring program to analyze records of opioid analgesic prescriptions dispensed to opioid‐naïve individuals in high (N = 26) and low (N = 94) broadband access counties during 3 periods: before a state of emergency (SOE) and executive order (EO) limiting nonemergent health care services (January 2019‐February 2020), while the EO was active (March‐April 2020), and after health care services began reopening (May‐December 2020). Marginal generalized estimating equations‐type negative binomial models were fit to compare prescription counts by broadband access over the 3 periods.FindingsRates of opioid dispensing to opioid‐naïve individuals decreased significantly during the EO, but increased nearly to pre‐SOE levels after health care services began reopening. Dispensing rates in low broadband counties were higher than those in high broadband counties during all time periods, although these differences were negligible after adjusting for potential confounders. During the EO, prescriptions were written for longer days’ supply in both county types.ConclusionsThe overall dramatic reduction in opioid prescribing rates should be considered when evaluating annual opioid prescribing trends. However, broadband subscription rate did not appear to influence opioid prescriptions dispensed in Kentucky during the EO.