Association Between State Opioid Prescribing Limits and Duration of Opioid Prescriptions From Dentists.
JAMA Netw Open
; 6(1): e2250409, 2023 01 03.
Article
en En
| MEDLINE
| ID: mdl-36630136
ABSTRACT
Importance In part to prevent the harms associated with dental opioid prescriptions, most states have enacted policies limiting the duration of opioid prescriptions for acute pain. Whether these limits are associated with changes in the duration of opioid prescriptions written by dentists is unclear. Objective:
To evaluate the association between state opioid prescribing limits and the duration of opioid prescriptions from dentists. Design, Setting, andParticipants:
This difference-in-differences cross-sectional study used data from the IQVIA Longitudinal Prescription Database, an all-payer database reporting prescription dispensing from 92% of retail pharmacies in the US. The sample included opioid prescriptions from dentists dispensed to children aged 0 to 17 years and adults 18 years or older from January 2014 through February 2020. Treatment states were those that implemented limits between January 2016 and December 2018. Control states were those that did not implement limits during the study period. Data on opioid prescribing limits were derived from the Prescription Drug Abuse Policy System. Data were analyzed from January 1 to September 30, 2022. Exposures State opioid prescribing limits. Main Outcomes andMeasures:
The outcome was opioid prescription duration, as measured by days' supply. The association between limits and duration was evaluated using a linear model with a 2-way fixed-effects specification. Covariates included patient characteristics, prescription characteristics, and indicators of implementation of prescription drug monitoring program use mandates. Separate analyses of data from adults and children were conducted owing to differences in the number of treatment states and restrictiveness of limits by age.Results:
The adult analysis included 56â¯607 314 opioid prescriptions for 34â¯364â¯775 patients (18â¯448â¯788 females [53.7%]; mean [SD] age at the earliest fill, 44.0 [17.4] years) in 22 treatment states and 12 control states. The child analysis included 3â¯720â¯837 opioid prescriptions for 3â¯165â¯880 patients (1â¯740â¯449 females [55.0%]; mean [SD] age at the earliest fill, 14.4 [3.5] years) in 23 treatment states and 12 control states. In both analyses, the median (25th-75th percentile) duration of opioid prescriptions was 3.0 (2-5) days. Implementation of limits, most of which allowed up to a 7-day supply of opioids, was not associated with changes in the duration of opioid prescriptions for adults (mean days' supply -0.06 days; 95% CI, -0.11 to <0.001 days) or children (mean days' supply -0.07 days; 95% CI, -0.15 to 0.02 days). Conclusions and Relevance In this study of national pharmacy dispensing data, opioid prescribing limits were not associated with changes in the duration of opioid prescriptions from dentists. Future research should investigate the potential role of alternative interventions in reducing opioid prescribing by dentists.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Pautas de la Práctica en Medicina
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Analgésicos Opioides
Tipo de estudio:
Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Child
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Female
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Humans
Idioma:
En
Revista:
JAMA Netw Open
Año:
2023
Tipo del documento:
Article