Coprescribing of opioids and high-risk medications in the USA: a cross-sectional study with data from national ambulatory and emergency department settings. Issue 6 (16th June 2022)

• Record Type: Journal Article
• Authors: Suvada, Kara; Zimmer, Anna; Soodalter, Jesse; Malik, Jimi S; Kavalieratos, Dio; Ali, Mohammed K
• Is Part Of: BMJ open. Volume 12:Issue 6(2022)
• Publication Date: 2022-06-16
• Subjects: risk management -- epidemiology -- pain management -- primary care; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-057588
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: Describe trends in opioid plus high-risk medication coprescribing in the USA. Design: Analyses of serial, cross-sectional, nationally representative data of the National Ambulatory Medical Care Survey (NAMCS) over 2007–2016 and the National Hospital Ambulatory Medical Care Survey (NHAMCS) over 2007–2018. Setting: US ambulatory (NAMCS) and emergency department (ED, NHAMCS) settings. Participants: Patient visits in which the patient was 18 years and older with an opioid prescription in the NAMCS or NHAMCS databases. Primary and secondary outcome measures: Frequency of opioid plus high-risk medication coprescribing. Results: From a combined sample of 700 499 visits over 2007–2018, there were 105 720 visits (15.1%) where opioids were prescribed. n=31 825 were from NAMCS and n=73 895 were from NHAMCS. The mean prevalence of coprescription of opioids and high-risk medications for the combined NAMCS and NHAMCS sample was 18.4% in 2007, peaked at 33.2% in 2014 and declined to 23.8% in 2016. Compared with adults receiving opioid prescriptions alone, those coprescribed opioids and high-risk medications were older, more likely female, white and using private or Medicare insurance (p<0.0001). Conclusions: Coprescribing is more common in ambulatory than ED settings and has been declining, yet one in four patient visits where opioids were prescribed resulted in coprescribed, high-risk medications in 2016. Efforts and research to help lower the rates of high-risk prescribing are needed.