Identifying opioid prescribing patterns for high-volume prescribers via cluster analysis
•Family medicine was the most common specialty prescribing high volumes of opioids.•Hydrocodone, followed by oxycodone, was the most frequently prescribed opioid type.•Southern clusters had consistently high volumes of prescribing across specialties.•Northeastern clusters had the least representatio...
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| Published in: | Drug and alcohol dependence Vol. 197; pp. 250 - 254 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Ireland
Elsevier B.V
01-04-2019
Elsevier Science Ltd |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | •Family medicine was the most common specialty prescribing high volumes of opioids.•Hydrocodone, followed by oxycodone, was the most frequently prescribed opioid type.•Southern clusters had consistently high volumes of prescribing across specialties.•Northeastern clusters had the least representation of high-prescribing specialties.•Emergency medicine specialists had some of the lowest median total prescriptions.
Despite recent decreases in opioid prescribing rates, evidence suggests there is substantial variation in the way opioids are prescribed by providers. This study aims to identify patterns in high-volume opioid prescribing.
We conducted partitioning-around-medoids cluster analysis using the IQVIA Prescriber Profile dataset, including the number of opioid prescriptions filled at US retail pharmacies aggregated at the prescriber-level from July 2016 through June 2017. Clustering was used to identify prescription patterns within a sample of 10,000 high-volume opioid prescribers (defined as the top 10% of prescribers by number of opioid prescriptions during the 12-month period). Clustering variables included prescription counts by opioid type, and prescriber specialty, age, and region.
Family medicine (32%), internal medicine (23%), and orthopedics (11%) were the most common high-volume prescribing specialties. Across specialties, hydrocodone and oxycodone were the most-frequently prescribed opioid types. Thirty-five clusters of prescribers were obtained, consistently comprised of a single majority specialty and region. All majority high-prescribing specialties were represented in Southern clusters, indicating consistently high volume opioid prescribing across specialties in the region. Prescribing patterns varied by drug type and region - across every Northeastern cluster, oxycodone prescribing was higher than hydrocodone. While clusters of pain medicine specialists had the highest median total prescriptions, emergency medicine specialist clusters had some of the lowest.
These results provide a clearer picture of current patterns among high-volume prescribers, who accounted for almost two-thirds of all opioid prescriptions. In light of the ongoing opioid overdose epidemic, this knowledge is critical for prevention activities. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Jan Losby assisted with the study design and interpretation of results, edited the manuscript, and approved the final manuscript as submitted. Contributors Nisha Nataraj led the study design, development and interpretation of results, conducted data analysis, drafted and edited the manuscript, and approved the final manuscript as submitted. Kun Zhang assisted with the study design, development, and interpretation of results, edited the manuscript, and approved the final manuscript as submitted. Gery Guy assisted with the study design, data preparation, and interpretation of results, edited the manuscript, and approved the final manuscript as submitted. |
| ISSN: | 0376-8716 1879-0046 |
| DOI: | 10.1016/j.drugalcdep.2019.01.012 |