Bo Kyum Yang1, Carla L Storr2, Alison M Trinkoff3, Minji Sohn4, Shannon K Idzik5, Mark McKinnon6. 1. Department of Health Sciences, College of Health Professions, Towson University, Towson, MD, United States of America. Electronic address: byang@towson.edu. 2. Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, United States of America. Electronic address: cstorr@umaryland.edu. 3. Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, United States of America. Electronic address: atrinkoff@umaryland.edu. 4. Department of Pharmaceutical Sciences, College of Pharmacy, Ferris State University, Big Rapids, MI, United States of America. Electronic address: MinjiSohn@ferris.edu. 5. Department of Organizational System and Adult Health, University of Maryland School of Nursing, Baltimore, MD, United States of America. Electronic address: idzik@umaryland.edu. 6. Department of Health Sciences, College of Health Professions, Towson University, Towson, MD, United States of America. Electronic address: mmckinnon@towson.edu.
Abstract
PURPOSE: To describe opioid prescribing practice patterns and trends in emergency department visits (EDs) by provider type: physicians and advanced practice providers (APPs), which include nurse practitioners (NPs) and physician assistants (PAs). METHODS: The data source was the ED visit files of the 2005-2015 National Hospital Ambulatory Care Survey. The study sample was opioid prescription-related ED visits. Descriptive and multinomial logistic regression analyses were conducted to assess the proportion of opioid prescription-related visits by provider type over time in total and by patient age group. We then characterized opioid prescribing practices of NPs, PAs, and physicians according to type of opioid and pain-related diagnosis. RESULTS: From 2005 to 2015, there was a 116.7% increase in the proportion of the opioid prescription-related visits seen by NPs and a 61.2% increase seen by both APPs and physicians. In contrast, the proportion of the physician-only visits decreased (-8.3%). When stratified by age group, the growth was particularly notable among the visits with patients aged 65 and older seen by both APPs and physicians (AOR = 2.35, 95% CI = 1.69, 3.25). Proportionally less hydromorphone and morphine was prescribed by APPs than by physicians. Opioids were prescribed more often by APPs in visits involving dental and injury-related pain, whereas physicians prescribed opioids more in abdominal and chest pain-related visits. CONCLUSIONS: From 2005 to 2015, APPs, particularly NPs played an increasing role in opioid prescribing in EDs. Opioid prescribing practices of APPs and physicians varied by patient condition as well as by opioid type.
PURPOSE: To describe opioid prescribing practice patterns and trends in emergency department visits (EDs) by provider type: physicians and advanced practice providers (APPs), which include nurse practitioners (NPs) and physician assistants (PAs). METHODS: The data source was the ED visit files of the 2005-2015 National Hospital Ambulatory Care Survey. The study sample was opioid prescription-related ED visits. Descriptive and multinomial logistic regression analyses were conducted to assess the proportion of opioid prescription-related visits by provider type over time in total and by patient age group. We then characterized opioid prescribing practices of NPs, PAs, and physicians according to type of opioid and pain-related diagnosis. RESULTS: From 2005 to 2015, there was a 116.7% increase in the proportion of the opioid prescription-related visits seen by NPs and a 61.2% increase seen by both APPs and physicians. In contrast, the proportion of the physician-only visits decreased (-8.3%). When stratified by age group, the growth was particularly notable among the visits with patients aged 65 and older seen by both APPs and physicians (AOR = 2.35, 95% CI = 1.69, 3.25). Proportionally less hydromorphone and morphine was prescribed by APPs than by physicians. Opioids were prescribed more often by APPs in visits involving dental and injury-related pain, whereas physicians prescribed opioids more in abdominal and chest pain-related visits. CONCLUSIONS: From 2005 to 2015, APPs, particularly NPs played an increasing role in opioid prescribing in EDs. Opioid prescribing practices of APPs and physicians varied by patient condition as well as by opioid type.
Authors: Sabina Schaffer; Dunya Bayat; Walter L Biffl; Jeffrey Smith; Kathryn B Schaffer; Tala H Dandan; Jiayan Wang; Deb Snyder; Chris Nalick; Imad S Dandan; Gail T Tominaga; Matthew R Castelo Journal: Trauma Surg Acute Care Open Date: 2022-03-24