| Title |
First Opioid Prescription and Subsequent High-Risk Opioid Use: a National Study of Privately Insured and Medicare Advantage Adults
|
|---|---|
| Published in |
Journal of General Internal Medicine, September 2018
|
| DOI | 10.1007/s11606-018-4628-y |
| Pubmed ID | |
| Authors |
Yongkang Zhang, Phyllis Johnson, Philip J. Jeng, M. Carrington Reid, Lisa R. Witkin, Bruce R. Schackman, Jessica S. Ancker, Yuhua Bao |
| Abstract |
National guidelines make recommendations regarding the initial opioid prescriptions, but most of the supporting evidence is from the initial episode of care, not the first prescription. To examine associations between features of the first opioid prescription and high-risk opioid use in the 18 months following the first prescription. Retrospective cohort study using data from a large commercial insurance claims database for 2011-2014 to identify individuals with no recent use of opioids and follow them for 18 months after the first opioid prescription. Privately insured patients aged 18-64 and Medicare Advantage patients aged 65 or older who filled a first opioid prescription between 07/01/2011 and 06/30/2013. High-risk opioid use was measured by having (1) opioid prescriptions overlapping for 7 days or more, (2) opioid and benzodiazepine prescriptions overlapping for 7 days or more, (3) three or more prescribers of opioids, and (4) a daily dosage exceeding 120 morphine milligram equivalents, in each of the six quarters following the first prescription. All three features of the first prescription were strongly associated with high-risk use. For example, among privately insured patients, receiving a long- (vs. short-) acting first opioid was associated with a 16.9-percentage-point increase (95% CI, 14.3-19.5), a daily MME of 50 or more (vs. less than 30) was associated with a 12.5-percentage-point increase (95% CI, 12.1-12.9), and a supply exceeding 7 days (vs. 3 or fewer days) was associated with a 4.8-percentage-point increase (95% CI, 4.5-5.2), in the probability of having a daily dosage of 120 MMEs or more in the long term, compared to a sample mean of 4.2%. Results for the Medicare Advantage patients were similar. Long-acting formulation, high daily dosage, and longer duration of the first opioid prescription were each associated with increased high-risk use of opioids in the long term. |
X Demographics
The data shown below were collected from the profiles of 8 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 6 | 75% |
| Unknown | 2 | 25% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 63% |
| Scientists | 2 | 25% |
| Science communicators (journalists, bloggers, editors) | 1 | 13% |
Mendeley readers
The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 43 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 7 | 16% |
| Student > Master | 6 | 14% |
| Student > Doctoral Student | 5 | 12% |
| Student > Bachelor | 3 | 7% |
| Researcher | 3 | 7% |
| Other | 7 | 16% |
| Unknown | 12 | 28% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 30% |
| Pharmacology, Toxicology and Pharmaceutical Science | 7 | 16% |
| Nursing and Health Professions | 6 | 14% |
| Unspecified | 1 | 2% |
| Psychology | 1 | 2% |
| Other | 3 | 7% |
| Unknown | 12 | 28% |
Attention Score in Context
This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 July 2019.
All research outputs
#1,913,535
of 23,911,072 outputs
Outputs from Journal of General Internal Medicine
#1,489
of 7,806 outputs
Outputs of similar age
#40,992
of 340,651 outputs
Outputs of similar age from Journal of General Internal Medicine
#25
of 119 outputs
Altmetric has tracked 23,911,072 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,806 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.8. This one has done well, scoring higher than 80% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 340,651 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 87% of its contemporaries.
We're also able to compare this research output to 119 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 78% of its contemporaries.