2013-2021 年美国医疗补助计划和医疗保险 D 部分的总体阿片类药物处方和长效阿片类药物处方的地域趋势。

IF 2.7 3区 医学 Q2 PSYCHOLOGY, CLINICAL American Journal of Drug and Alcohol Abuse Pub Date : 2024-10-15 DOI:10.1080/00952990.2024.2400916
Shanshan Wang, Matthew E Rossheim, Scott T Walters, Rajesh R Nandy, Kari Northeim
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引用次数: 0

摘要

背景:在全国阿片类药物流行之际,评估阿片类药物处方的趋势非常重要。长效类阿片(LAOs)是滥用最严重的处方类阿片之一,因此特别值得关注。此外,了解阿片类药物处方的地域趋势可能有助于确定州一级的差异,从而说明各州的具体差异:本研究旨在确定 2013 年至 2021 年医疗补助计划和医疗保险 D 部分中阿片类药物总处方量和 LAO 处方量的地域趋势:我们使用了美国医疗保险与医疗补助服务中心提供的 2013 年至 2021 年阿片类药物处方数据。阿片类药物处方比例的计算方法是:阿片类药物报销申请数量除以总体药物报销申请总数。LAO处方比例的计算方法是LAO申请数量除以阿片类药物申请总数:结果:尽管全国范围内阿片类药物处方比例普遍下降,但爱荷华州、蒙大拿州和弗吉尼亚州的医疗补助阿片类药物处方比例却有所上升。从 2017 年到 2021 年,全国范围内的医疗补助 LAO 处方比例呈上升趋势,增加了 14.1 个百分点(P 为年度百分比变化 [APC])结论:全国范围内的医疗补助 LAO 处方比例呈上升趋势,增加了 14.1 个百分点(P 为年度百分比变化 [APC]):爱荷华州、蒙大拿州和弗吉尼亚州的国家级医疗补助 LAO 处方和医疗补助阿片类药物处方的增加趋势令人担忧,并对阿片类药物的临床处方产生影响。医疗保险 D 部分的减少趋势可能反映了阿片类药物处方管理方面的持续努力。
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Geographic trends in overall and long-acting opioid prescriptions under Medicaid and Medicare Part D in the United States, 2013-2021.

Background: Amid the national opioid epidemic, it is important to assess trends in opioid prescriptions. Long-acting opioids (LAOs) are of particular interest as they are among the most intensely misused prescription opioids. Moreover, understanding geographic trends in opioid prescriptions may help identify state-level variations, illustrating state-specific disparities.Objectives: The study aims to determine geographic trends in overall and LAO prescriptions under Medicaid and Medicare Part D from 2013 to 2021.Methods: We used data from the Centers for Medicare & Medicaid Services on opioid prescriptions from 2013 to 2021. The opioid prescribing proportion was calculated as the number of opioid claims divided by the total number of overall drug claims. The LAO prescribing proportion was calculated as number of LAO claims divided by total opioid claims.Results: Despite a general decrease nationwide, Medicaid opioid prescribing proportions increased in Iowa, Montana, and Virginia. There was an increasing trend in the national-level Medicaid LAO prescribing proportion from 2017 to 2021, with a 14.1% point increase (p for the annual percent change [APC]<0.05). For Medicare Part D, the overall prescribing proportions fell by 1.7% points from 2013 to 2021, while the LAO prescribing proportion fell by 3% points from 2016 to 2021 (p for APC < .05).Conclusions: The increasing trends in national-level Medicaid LAO prescribing and Medicaid opioid prescribing in Iowa, Montana, and Virginia are concerning, and have implications for clinical opioid prescribing. The decreasing trends in Medicare Part D may reflect ongoing efforts in opioid prescription management.

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来源期刊
CiteScore
4.70
自引率
3.70%
发文量
68
期刊介绍: The American Journal of Drug and Alcohol Abuse (AJDAA) is an international journal published six times per year and provides an important and stimulating venue for the exchange of ideas between the researchers working in diverse areas, including public policy, epidemiology, neurobiology, and the treatment of addictive disorders. AJDAA includes a wide range of translational research, covering preclinical and clinical aspects of the field. AJDAA covers these topics with focused data presentations and authoritative reviews of timely developments in our field. Manuscripts exploring addictions other than substance use disorders are encouraged. Reviews and Perspectives of emerging fields are given priority consideration. Areas of particular interest include: public health policy; novel research methodologies; human and animal pharmacology; human translational studies, including neuroimaging; pharmacological and behavioral treatments; new modalities of care; molecular and family genetic studies; medicinal use of substances traditionally considered substances of abuse.
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