Changes in postoperative opioid prescribing across three diverse healthcare systems, 2010–2020
ObjectiveThe opioid crisis brought scrutiny to opioid prescribing. Understanding how opioid prescribing patterns and corresponding patient outcomes changed during the epidemic is essential for future targeted policies. Many studies attempt to model trends in opioid prescriptions therefore understand...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Digital Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fdgth.2022.995497/full |
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| author | Jean Coquet Alban Zammit Oualid El Hajouji Keith Humphreys Keith Humphreys Steven M. Asch Steven M. Asch Thomas F. Osborne Thomas F. Osborne Catherine M. Curtin Catherine M. Curtin Tina Hernandez-Boussard Tina Hernandez-Boussard Tina Hernandez-Boussard |
| author_facet | Jean Coquet Alban Zammit Oualid El Hajouji Keith Humphreys Keith Humphreys Steven M. Asch Steven M. Asch Thomas F. Osborne Thomas F. Osborne Catherine M. Curtin Catherine M. Curtin Tina Hernandez-Boussard Tina Hernandez-Boussard Tina Hernandez-Boussard |
| author_sort | Jean Coquet |
| collection | DOAJ |
| description | ObjectiveThe opioid crisis brought scrutiny to opioid prescribing. Understanding how opioid prescribing patterns and corresponding patient outcomes changed during the epidemic is essential for future targeted policies. Many studies attempt to model trends in opioid prescriptions therefore understanding the temporal shift in opioid prescribing patterns across populations is necessary. This study characterized postoperative opioid prescribing patterns across different populations, 2010–2020.Data SourceAdministrative data from Veteran Health Administration (VHA), six Medicaid state programs and an Academic Medical Center (AMC).Data extractionSurgeries were identified using the Clinical Classifications Software.Study DesignTrends in average daily discharge Morphine Milligram Equivalent (MME), postoperative pain and subsequent opioid prescription were compared using regression and likelihood ratio test statistics.Principal FindingsThe cohorts included 595,106 patients, with populations that varied considerably in demographics. Over the study period, MME decreased significantly at VHA (37.5–30.1; p = 0.002) and Medicaid (41.6–31.3; p = 0.019), and increased at AMC (36.9–41.7; p < 0.001). Persistent opioid users decreased after 2015 in VHA (p < 0.001) and Medicaid (p = 0.002) and increase at the AMC (p = 0.003), although a low rate was maintained. Average postoperative pain scores remained constant over the study period.ConclusionsVHA and Medicaid programs decreased opioid prescribing over the past decade, with differing response times and rates. In 2020, these systems achieved comparable opioid prescribing patterns and outcomes despite having very different populations. Acknowledging and incorporating these temporal distribution shifts into data learning models is essential for robust and generalizable models. |
| first_indexed | 2024-04-11T06:31:59Z |
| format | Article |
| id | doaj.art-aa6119688e964d82b6814380fe9cf97d |
| institution | Directory Open Access Journal |
| issn | 2673-253X |
| language | English |
| last_indexed | 2024-04-11T06:31:59Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Digital Health |
| spelling | doaj.art-aa6119688e964d82b6814380fe9cf97d2022-12-22T04:40:01ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2022-12-01410.3389/fdgth.2022.995497995497Changes in postoperative opioid prescribing across three diverse healthcare systems, 2010–2020Jean Coquet0Alban Zammit1Oualid El Hajouji2Keith Humphreys3Keith Humphreys4Steven M. Asch5Steven M. Asch6Thomas F. Osborne7Thomas F. Osborne8Catherine M. Curtin9Catherine M. Curtin10Tina Hernandez-Boussard11Tina Hernandez-Boussard12Tina Hernandez-Boussard13Department of Medicine, Stanford University School of Medicine, Stanford, CA, United StatesComputational & Mathematical Engineering, Stanford University, Stanford, CA, United StatesComputational & Mathematical Engineering, Stanford University, Stanford, CA, United StatesUnited States Department of Veterans Affairs, Palo Alto Healthcare System, Palo Alto, CA, United StatesDepartment of Psychiatry, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Medicine, Stanford University School of Medicine, Stanford, CA, United StatesUnited States Department of Veterans Affairs, Palo Alto Healthcare System, Palo Alto, CA, United StatesUnited States Department of Veterans Affairs, Palo Alto Healthcare System, Palo Alto, CA, United StatesDepartment of Radiology, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Surgery, VA Palo Alto Health Care System, Menlo Park, CA, United StatesDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Medicine, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Biomedical Data Science, Stanford University, Stanford, CA, United StatesObjectiveThe opioid crisis brought scrutiny to opioid prescribing. Understanding how opioid prescribing patterns and corresponding patient outcomes changed during the epidemic is essential for future targeted policies. Many studies attempt to model trends in opioid prescriptions therefore understanding the temporal shift in opioid prescribing patterns across populations is necessary. This study characterized postoperative opioid prescribing patterns across different populations, 2010–2020.Data SourceAdministrative data from Veteran Health Administration (VHA), six Medicaid state programs and an Academic Medical Center (AMC).Data extractionSurgeries were identified using the Clinical Classifications Software.Study DesignTrends in average daily discharge Morphine Milligram Equivalent (MME), postoperative pain and subsequent opioid prescription were compared using regression and likelihood ratio test statistics.Principal FindingsThe cohorts included 595,106 patients, with populations that varied considerably in demographics. Over the study period, MME decreased significantly at VHA (37.5–30.1; p = 0.002) and Medicaid (41.6–31.3; p = 0.019), and increased at AMC (36.9–41.7; p < 0.001). Persistent opioid users decreased after 2015 in VHA (p < 0.001) and Medicaid (p = 0.002) and increase at the AMC (p = 0.003), although a low rate was maintained. Average postoperative pain scores remained constant over the study period.ConclusionsVHA and Medicaid programs decreased opioid prescribing over the past decade, with differing response times and rates. In 2020, these systems achieved comparable opioid prescribing patterns and outcomes despite having very different populations. Acknowledging and incorporating these temporal distribution shifts into data learning models is essential for robust and generalizable models.https://www.frontiersin.org/articles/10.3389/fdgth.2022.995497/fullopioidtemporal pattern miningsurgerypostoperative painprescribing patterns |
| spellingShingle | Jean Coquet Alban Zammit Oualid El Hajouji Keith Humphreys Keith Humphreys Steven M. Asch Steven M. Asch Thomas F. Osborne Thomas F. Osborne Catherine M. Curtin Catherine M. Curtin Tina Hernandez-Boussard Tina Hernandez-Boussard Tina Hernandez-Boussard Changes in postoperative opioid prescribing across three diverse healthcare systems, 2010–2020 Frontiers in Digital Health opioid temporal pattern mining surgery postoperative pain prescribing patterns |
| title | Changes in postoperative opioid prescribing across three diverse healthcare systems, 2010–2020 |
| title_full | Changes in postoperative opioid prescribing across three diverse healthcare systems, 2010–2020 |
| title_fullStr | Changes in postoperative opioid prescribing across three diverse healthcare systems, 2010–2020 |
| title_full_unstemmed | Changes in postoperative opioid prescribing across three diverse healthcare systems, 2010–2020 |
| title_short | Changes in postoperative opioid prescribing across three diverse healthcare systems, 2010–2020 |
| title_sort | changes in postoperative opioid prescribing across three diverse healthcare systems 2010 2020 |
| topic | opioid temporal pattern mining surgery postoperative pain prescribing patterns |
| url | https://www.frontiersin.org/articles/10.3389/fdgth.2022.995497/full |
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