Inappropriate Opioid Prescribing in Oregon's Coordinated Care Organizations

Area of Science:

• Health Services Research
• Pharmacology
• Public Health

Background:

• Opioid prescribing for pain management presents significant public health challenges.
• Understanding patterns of potentially inappropriate opioid prescriptions is crucial for targeted interventions.

Purpose of the Study:

• To identify demographic and clinical factors associated with potentially inappropriate opioid prescriptions among Oregon Medicaid patients with pain diagnoses.
• To analyze trends in inappropriate opioid prescribing over a five-year period.

Main Methods:

• Utilized de-identified Oregon Medicaid claims data from 2010-2014.
• Employed logistic regression models to identify factors linked to inappropriate opioid prescriptions.
• Included over 118,000 unique patients with pain diagnoses.

Main Results:

• The rate of patients receiving at least one inappropriate opioid prescription decreased from 32.5% in 2010 to 22.3% in 2014.
• White race, older age, chronic health conditions, psychiatric disorders, and substance use disorder were associated with higher odds of inappropriate opioid prescriptions.
• Findings were consistent across patients with acute, chronic, or both types of pain.

Conclusions:

• While inappropriate opioid prescribing declined in Oregon Medicaid, nearly a quarter of patients still received them in 2014.
• Further strategies are necessary to minimize inappropriate opioid use.
• Recommendations include enhanced prescription drug monitoring, pain clinic legislation, and prior authorization policies.