Opioid Prescribing Rates in Nonmetropolitan and Metropolitan Counties Among Primary Care Providers Using an Electronic Health Record System - United States, 2014-2017
| Autor: | Katherine Hempstead, Charles M. Heilig, Mark Faul, Gery P. Guy, Dorrie Raymond, Macarena C. García, Scott H. Lee, Josh Gray, Michael F. Iademarco |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Health (social science) Epidemiology Health Toxicology and Mutagenesis Poison control Drug overdose 01 natural sciences Drug Prescriptions Occupational safety and health Physicians Primary Care 03 medical and health sciences 0302 clinical medicine Health Information Management Environmental health Injury prevention medicine Urban Health Services Electronic Health Records Humans 030212 general & internal medicine Full Report 0101 mathematics Medical prescription Practice Patterns Physicians' business.industry Public health 010102 general mathematics General Medicine Guideline medicine.disease Metropolitan area United States Analgesics Opioid Rural Health Services business |
| Zdroj: | Morbidity and Mortality Weekly Report |
| ISSN: | 1545-861X |
| Popis: | Drug overdose is the leading cause of unintentional injury-associated death in the United States. Among 70,237 fatal drug overdoses in 2017, prescription opioids were involved in 17,029 (24.2%) (1). Higher rates of opioid-related deaths have been recorded in nonmetropolitan (rural) areas (2). In 2017, 14 rural counties were among the 15 counties with the highest opioid prescribing rates.* Higher opioid prescribing rates put patients at risk for addiction and overdose (3). Using deidentified data from the Athenahealth electronic health record (EHR) system, opioid prescribing rates among 31,422 primary care providers† in the United States were analyzed to evaluate trends from January 2014 to March 2017. This analysis assessed how prescribing practices varied among six urban-rural classification categories of counties, before and after the March 2016 release of CDC's Guideline for Prescribing Opioids for Chronic Pain (Guideline) (4). Patients in noncore (the most rural) counties had an 87% higher chance of receiving an opioid prescription compared with persons in large central metropolitan counties during the study period. Across all six county groups, the odds of receiving an opioid prescription decreased significantly after March 2016. This decrease followed a flat trend during the preceding period in micropolitan and large central metropolitan county groups; in contrast, the decrease continued previous downward trends in the other four county groups. Data from EHRs can effectively supplement traditional surveillance methods for monitoring trends in opioid prescribing and other areas of public health importance, with minimal lag time under ideal conditions. As less densely populated areas appear to indicate both substantial progress in decreasing opioid prescribing and ongoing need for reduction, community health care practices and intervention programs must continue to be tailored to community characteristics. |
| Databáze: | OpenAIRE |
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