Adeleke D Adewumi1, Joemer C Maravilla2, Rosa Alati3, Samantha A Hollingworth4, Xuelei Hu5, Bill Loveday6, Jason P Connor7. 1. Maryborough Hospital Pharmacy, Wide Bay Hospital and Health Service, 185 Walker Street, Maryborough 4650, Queensland, Australia; Discipline of Psychiatry, The University of Queensland, Herston, Queensland 4029, Australia; School of Clinical Medicine - Rural Clinical School, The University of Queensland, 2-4 Medical Place Urraween, QLD 4655, Queensland, Australia. Electronic address: a.adewumi@uqconnect.edu.au. 2. Institute for Social Science Research, The University of Queensland, 80 Meiers Rd, Indooroopilly, QLD 4068, Australia. 3. School of Public Health, Curtin University, Kent Street, Bentley Campus, Perth, Western Australia 6845, Australia. 4. School of Pharmacy, The University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4102 Australia. 5. School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD 4072, Australia. 6. Monitored Medicines Unit, Chief Medical Officer & Healthcare Regulation Branch, Department of Health, Brisbane, Australia. 7. Centre for Youth Substance Abuse Research, The University of Queensland, 17 Upland Road, St Lucia, QLD 4067, Australia; Discipline of Psychiatry, The University of Queensland, Herston, Queensland 4029, Australia.
Abstract
BACKGROUND: Accessing multiple prescribers for opioid prescription, referred to as doctor-shopping, is associated with an increased risk of opioid overdose and fatalities. AIM: The primary aim of this study was to assess the probability of accessing multiple prescribers among patients dispensed prescription opioids. METHOD: A retrospective population-based study using the Monitoring of Drugs of Dependence system of the Medicines Monitoring Unit (MMU) of Queensland Health, Australia. We assessed the odds of accessing multiple prescribers across both -short-term (≤1 month, 2-3 months) and longer-term (4-6 months and ≥7 months). We examined the relationship between multiple doctor visits, the dispensed dose of opioid and patient's residential socioeconomic status (SES). RESULT: Compared to those dispensed opioid prescriptions for ≥7-12 months, those dispensed opioids for ≤1 month were more likely to have visited ≥3 prescribers (adjusted odds ratio (aOR)) 4.06, 95% CI 4.01, 4.10, while for 2-3 months and 4-6 months the odds were aOR 2.36, 95% CI 2.33, 2.39 and aOR 1.79, 95% CI 1.74, 1.79 respectively. Patients dispensed opioid doses of ≥100 oral morphine milligram equivalent per day (MME/day) were more likely to obtain prescriptions from ≥3 prescribers compare to those receiving a dose of <20MME/day (aOR 1.90; 95% CI 1.87, 1.94). The probability of obtaining opioid prescriptions from multiple prescribers increased as the socioeconomic status decreased: aOR 1.41; 95% CI 1.38, 1.44 for lowest SES compared to the highest SES. CONCLUSION: Patients were more than four time likely to be dispensed opioid prescriptions from multiple prescribers within the first 30 days of initiating opioid treatment, possibly as part of multidisciplinary referral post-hospital discharge. High dose opioid and low SES was associated with higher probability of accessing multiple prescribers.
BACKGROUND: Accessing multiple prescribers for opioid prescription, referred to as doctor-shopping, is associated with an increased risk of opioid overdose and fatalities. AIM: The primary aim of this study was to assess the probability of accessing multiple prescribers among patients dispensed prescription opioids. METHOD: A retrospective population-based study using the Monitoring of Drugs of Dependence system of the Medicines Monitoring Unit (MMU) of Queensland Health, Australia. We assessed the odds of accessing multiple prescribers across both -short-term (≤1 month, 2-3 months) and longer-term (4-6 months and ≥7 months). We examined the relationship between multiple doctor visits, the dispensed dose of opioid and patient's residential socioeconomic status (SES). RESULT: Compared to those dispensed opioid prescriptions for ≥7-12 months, those dispensed opioids for ≤1 month were more likely to have visited ≥3 prescribers (adjusted odds ratio (aOR)) 4.06, 95% CI 4.01, 4.10, while for 2-3 months and 4-6 months the odds were aOR 2.36, 95% CI 2.33, 2.39 and aOR 1.79, 95% CI 1.74, 1.79 respectively. Patients dispensed opioid doses of ≥100 oral morphine milligram equivalent per day (MME/day) were more likely to obtain prescriptions from ≥3 prescribers compare to those receiving a dose of <20MME/day (aOR 1.90; 95% CI 1.87, 1.94). The probability of obtaining opioid prescriptions from multiple prescribers increased as the socioeconomic status decreased: aOR 1.41; 95% CI 1.38, 1.44 for lowest SES compared to the highest SES. CONCLUSION:Patients were more than four time likely to be dispensed opioid prescriptions from multiple prescribers within the first 30 days of initiating opioid treatment, possibly as part of multidisciplinary referral post-hospital discharge. High dose opioid and low SES was associated with higher probability of accessing multiple prescribers.
Authors: Adeleke D Adewumi; Joemer C Maravilla; Rosa Alati; Samantha A Hollingworth; Xuelei Hu; Bill Loveday; Jason P Connor Journal: Int J Clin Pharm Date: 2020-09-23
Authors: Chris Delcher; Daniel R Harris; Changwe Park; Gail K Strickler; Jeffery Talbert; Patricia R Freeman Journal: Drug Alcohol Depend Date: 2021-02-15 Impact factor: 4.492