Literature DB >> 30034551

Opioids in Georgia Medicaid: Gender and Insurance Disparities in Utilization and Potential Inappropriate Prescribing Practices.

Jayani Jayawardhana1, Amanda J Abraham2, Henry N Young1, Matthew Perri3.   

Abstract

OBJECTIVES: Medicaid populations have been disproportionately affected by the opioid epidemic. In Georgia, opioid deaths have increased at more than twice the rate of the nation at large. It is unknown if certain populations within the Medicaid unduly receive opioid prescriptions or experience inappropriate prescribing of opioids. Thus, this study examines gender and insurance disparities in the use of opioids and the prevalence of indicators for potential inappropriate prescribing of opioids in the Georgia Medicaid population.
METHODS: Using individual Georgia Medicaid pharmacy claims data from 2012, disparities across gender (male/female) and type of insurance (fee-for-service (FFS)/managed care (MC)) were examined for the general use of opioids and potential inappropriate prescribing practices by providers. These outcome measures were taken from previous clinical guidelines and expert panels. T-tests were conducted to estimate significance in disparities across gender and type of insurance. KEY
FINDINGS: Average number of opioid prescriptions received and average days of supply of opioids were higher among males than females (p<0.001), and among FFS patients than MC patients (p<0.001). Similarly, average incidences of potential inappropriate prescribing of opioids were higher among males (1.41) than females (0.83) (p<0.001), and among FFS patients (1.60) than MC patients (0.46) (p<0.001).
CONCLUSIONS: Results indicate statistically significant disparities among male/female patients and FFS/MC patients in the general use of opioids and in potential inappropriate prescribing of opioids. Policies aimed at curbing potential inappropriate prescribing of opioids, especially among male and FFS enrollees are needed to reduce prescription drug abuse within this population.

Entities:  

Keywords:  Medicaid; Opioids; fee-for-service; gender; inappropriate prescribing; managed care

Year:  2018        PMID: 30034551      PMCID: PMC6051715          DOI: 10.1111/jphs.12215

Source DB:  PubMed          Journal:  J Pharm Health Serv Res        ISSN: 1759-8885


  19 in total

1.  Training for general practitioners in opioid prescribing for chronic pain based on practice guidelines: a randomized pilot and feasibility trial.

Authors:  Lance M McCracken; Charlotte Boichat; Christopher Eccleston
Journal:  J Pain       Date:  2011-11-23       Impact factor: 5.820

2.  Patterns of Opioid Use and Risk of Opioid Overdose Death Among Medicaid Patients.

Authors:  Renu K Garg; Deborah Fulton-Kehoe; Gary M Franklin
Journal:  Med Care       Date:  2017-07       Impact factor: 2.983

3.  ACOEM practice guidelines: opioids for treatment of acute, subacute, chronic, and postoperative pain.

Authors:  Kurt T Hegmann; Michael S Weiss; Kirk Bowden; Fernando Branco; Kimberly DuBrueler; Charl Els; Steven Mandel; David W McKinney; Rafael Miguel; Kathryn L Mueller; Robert J Nadig; Michael I Schaffer; Larry Studt; James B Talmage; Russell L Travis; Thomas Winters; Matthew S Thiese; Jeffrey S Harris
Journal:  J Occup Environ Med       Date:  2014-12       Impact factor: 2.162

4.  Prescription opioid analgesic use among adults: United States, 1999-2012.

Authors:  Steven M Frenk; Kathryn S Porter; Leonard J Paulozzi
Journal:  NCHS Data Brief       Date:  2015-02

5.  CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016.

Authors:  Deborah Dowell; Tamara M Haegerich; Roger Chou
Journal:  MMWR Recomm Rep       Date:  2016-03-18

6.  Prescription practices involving opioid analgesics among Americans with Medicaid, 2010.

Authors:  Karin A Mack; Kun Zhang; Leonard Paulozzi; Christopher Jones
Journal:  J Health Care Poor Underserved       Date:  2015-02

7.  The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013.

Authors:  Curtis S Florence; Chao Zhou; Feijun Luo; Likang Xu
Journal:  Med Care       Date:  2016-10       Impact factor: 2.983

8.  Early opioid prescription and subsequent disability among workers with back injuries: the Disability Risk Identification Study Cohort.

Authors:  Gary M Franklin; Bert D Stover; Judith A Turner; Deborah Fulton-Kehoe; Thomas M Wickizer
Journal:  Spine (Phila Pa 1976)       Date:  2008-01-15       Impact factor: 3.468

9.  Potential misuse and inappropriate prescription practices involving opioid analgesics.

Authors:  Ying Liu; Joseph E Logan; Leonard J Paulozzi; Kun Zhang; Christopher M Jones
Journal:  Am J Manag Care       Date:  2013-08       Impact factor: 2.229

10.  Improving opioid safety practices in primary care: protocol for the development and evaluation of a multifaceted, theory-informed pilot intervention for healthcare providers.

Authors:  Pamela Leece; Daniel Z Buchman; Michael Hamilton; Caitlyn Timmings; Yalnee Shantharam; Julia Moore; Andrea D Furlan
Journal:  BMJ Open       Date:  2017-04-26       Impact factor: 2.692

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  5 in total

1.  Medical use, non-medical use and use disorders of benzodiazepines and prescription opioids in adults: Differences by insurance status.

Authors:  Vítor Soares Tardelli; Thiago Marques Fidalgo; Julian Santaella; Silvia S Martins
Journal:  Drug Alcohol Depend       Date:  2019-09-21       Impact factor: 4.492

2.  Inappropriate Opioid Prescribing in Oregon's Coordinated Care Organizations.

Authors:  Amanda J Abraham; Traci Rieckmann; Yifan Gu; Bonnie K Lind
Journal:  J Addict Med       Date:  2020 Jul/Aug       Impact factor: 3.702

3.  Deaths among opioid users: impact of potential inappropriate prescribing practices.

Authors:  Jayani Jayawardhana; Amanda J Abraham; Matthew Perri
Journal:  Am J Manag Care       Date:  2019-04-01       Impact factor: 2.229

4.  Opioid Analgesics in Georgia Medicaid: Trends in Potential Inappropriate Prescribing Practices by Demographic Characteristics, 2009-2014.

Authors:  Jayani Jayawardhana; Amanda J Abraham; Matthew Perri
Journal:  J Manag Care Spec Pharm       Date:  2018-09

Review 5.  Misalignment of Stakeholder Incentives in the Opioid Crisis.

Authors:  Alireza Boloori; Bengt B Arnetz; Frederi Viens; Taps Maiti; Judith E Arnetz
Journal:  Int J Environ Res Public Health       Date:  2020-10-16       Impact factor: 3.390

  5 in total

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