Information on doctor and pharmacy shopping for opioids adds little to the identification of presumptive opioid abuse disorders in health insurance claims data
Alexander M Walker,1 Lisa B Weatherby,1 M Soledad Cepeda,2 Daniel C Bradford3 1World Health Information Science Consultants, Dedham, MA, USA; 2Janssen Research and Development, Titusville, NJ, USA; 3Advanced Analytics, IQVIA, Plymouth Meeting, PA, USABackground: Doctor and pharmacy shopping (&ld...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-08-01
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| Series: | Substance Abuse and Rehabilitation |
| Subjects: | |
| Online Access: | https://www.dovepress.com/information-on-doctor-and-pharmacy-shopping-for-opioids-adds-little-to-peer-reviewed-article-SAR |
| _version_ | 1818196032172851200 |
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| author | Walker AM Weatherby LB Cepeda MS Bradford DC |
| author_facet | Walker AM Weatherby LB Cepeda MS Bradford DC |
| author_sort | Walker AM |
| collection | DOAJ |
| description | Alexander M Walker,1 Lisa B Weatherby,1 M Soledad Cepeda,2 Daniel C Bradford3
1World Health Information Science Consultants, Dedham, MA, USA; 2Janssen Research and Development, Titusville, NJ, USA; 3Advanced Analytics, IQVIA, Plymouth Meeting, PA, USABackground: Doctor and pharmacy shopping (“Shopping”) for opioids is related to opioid abuse and is associated with opioid overdose and death. Lacking identifiers for prescribers and pharmacies, many data resources (notably the US FDA’s Sentinel System) cannot evaluate Shopping. We used data in which presumptive Shopping could be identified. We investigated whether US health insurance claims data could perform as well as Shopping to identify people with evidence for opioid abuse.Methods: In this cross-sectional study, we examined health insurance claims from 164,923 persons with at least two dispensing of opioids in 18 months, the first occurring in 2012. Evidence for the presence of a possible opioid abuse disorder was drawn from predictive patterns of drug fills, diagnoses and care-seeking identified in a companion research project, and Shopping was determined using a published index. The prevalence of presumptive opioid abuse was examined across levels of Shopping. The comparison between Shopping and insurance-claims-derived covariates in the detection of apparent opioid abuse was examined in multiple regression analyses.Results: Despite a strong correlation between presumptive opioid abuse and Shopping, most persons with extensive Shopping did not manifest presumptive opioid abuse, and half of the population with presumptive opioid abuse did not exhibit Shopping. As Shopping ranged from “None” to “Extensive,” the prevalence of presumptive opioid abuse increased from 0.28 to 5.0 per 100. The discriminating power of Shopping for identifying opioid abuse could be replaced using insurance claims data.Conclusion: The results suggest that patient characteristics that can be inferred from insurance claims data provide as complete discrimination of persons with presumptive opioid abuse as does a full assessment of doctor and pharmacy shopping. The inference rests on patterns of health services and drug dispensing that are indicative of doctor–pharmacy shopping and of opioid abuse. There was no direct evaluation of patients. The extent to which the conclusions are generalizable beyond the study population – Americans with health insurance coverage in the early part of this decade – is uncertain in a quantitative sense. The qualitative conclusion is that diagnostic data in health insurance databases can be predictive of behaviors consistent with opioid abuse and that more elaborate indices such as doctor and pharmacy shopping may add little.Registration: ClinicalTrials.gov study number: NCT02668549.Keywords: doctor and pharmacy shopping, opioids, abuse, screening, prediction |
| first_indexed | 2024-12-12T01:27:38Z |
| format | Article |
| id | doaj.art-d16a4d86bc194d37a90a97f1b10cdd38 |
| institution | Directory Open Access Journal |
| issn | 1179-8467 |
| language | English |
| last_indexed | 2024-12-12T01:27:38Z |
| publishDate | 2019-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Substance Abuse and Rehabilitation |
| spelling | doaj.art-d16a4d86bc194d37a90a97f1b10cdd382022-12-22T00:43:03ZengDove Medical PressSubstance Abuse and Rehabilitation1179-84672019-08-01Volume 10475547582Information on doctor and pharmacy shopping for opioids adds little to the identification of presumptive opioid abuse disorders in health insurance claims dataWalker AMWeatherby LBCepeda MSBradford DCAlexander M Walker,1 Lisa B Weatherby,1 M Soledad Cepeda,2 Daniel C Bradford3 1World Health Information Science Consultants, Dedham, MA, USA; 2Janssen Research and Development, Titusville, NJ, USA; 3Advanced Analytics, IQVIA, Plymouth Meeting, PA, USABackground: Doctor and pharmacy shopping (“Shopping”) for opioids is related to opioid abuse and is associated with opioid overdose and death. Lacking identifiers for prescribers and pharmacies, many data resources (notably the US FDA’s Sentinel System) cannot evaluate Shopping. We used data in which presumptive Shopping could be identified. We investigated whether US health insurance claims data could perform as well as Shopping to identify people with evidence for opioid abuse.Methods: In this cross-sectional study, we examined health insurance claims from 164,923 persons with at least two dispensing of opioids in 18 months, the first occurring in 2012. Evidence for the presence of a possible opioid abuse disorder was drawn from predictive patterns of drug fills, diagnoses and care-seeking identified in a companion research project, and Shopping was determined using a published index. The prevalence of presumptive opioid abuse was examined across levels of Shopping. The comparison between Shopping and insurance-claims-derived covariates in the detection of apparent opioid abuse was examined in multiple regression analyses.Results: Despite a strong correlation between presumptive opioid abuse and Shopping, most persons with extensive Shopping did not manifest presumptive opioid abuse, and half of the population with presumptive opioid abuse did not exhibit Shopping. As Shopping ranged from “None” to “Extensive,” the prevalence of presumptive opioid abuse increased from 0.28 to 5.0 per 100. The discriminating power of Shopping for identifying opioid abuse could be replaced using insurance claims data.Conclusion: The results suggest that patient characteristics that can be inferred from insurance claims data provide as complete discrimination of persons with presumptive opioid abuse as does a full assessment of doctor and pharmacy shopping. The inference rests on patterns of health services and drug dispensing that are indicative of doctor–pharmacy shopping and of opioid abuse. There was no direct evaluation of patients. The extent to which the conclusions are generalizable beyond the study population – Americans with health insurance coverage in the early part of this decade – is uncertain in a quantitative sense. The qualitative conclusion is that diagnostic data in health insurance databases can be predictive of behaviors consistent with opioid abuse and that more elaborate indices such as doctor and pharmacy shopping may add little.Registration: ClinicalTrials.gov study number: NCT02668549.Keywords: doctor and pharmacy shopping, opioids, abuse, screening, predictionhttps://www.dovepress.com/information-on-doctor-and-pharmacy-shopping-for-opioids-adds-little-to-peer-reviewed-article-SARDoctor/pharmacy shoppingopioidsabusescreeningprediction |
| spellingShingle | Walker AM Weatherby LB Cepeda MS Bradford DC Information on doctor and pharmacy shopping for opioids adds little to the identification of presumptive opioid abuse disorders in health insurance claims data Substance Abuse and Rehabilitation Doctor/pharmacy shopping opioids abuse screening prediction |
| title | Information on doctor and pharmacy shopping for opioids adds little to the identification of presumptive opioid abuse disorders in health insurance claims data |
| title_full | Information on doctor and pharmacy shopping for opioids adds little to the identification of presumptive opioid abuse disorders in health insurance claims data |
| title_fullStr | Information on doctor and pharmacy shopping for opioids adds little to the identification of presumptive opioid abuse disorders in health insurance claims data |
| title_full_unstemmed | Information on doctor and pharmacy shopping for opioids adds little to the identification of presumptive opioid abuse disorders in health insurance claims data |
| title_short | Information on doctor and pharmacy shopping for opioids adds little to the identification of presumptive opioid abuse disorders in health insurance claims data |
| title_sort | information on doctor and pharmacy shopping for opioids adds little to the identification of presumptive opioid abuse disorders in health insurance claims data |
| topic | Doctor/pharmacy shopping opioids abuse screening prediction |
| url | https://www.dovepress.com/information-on-doctor-and-pharmacy-shopping-for-opioids-adds-little-to-peer-reviewed-article-SAR |
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