Prevalence and factors associated with multiple provider episodes in Texas: An epidemiological analysis of prescription drug monitoring program data

Erin A. Ferries, Aaron M. Gilson, Rajendar R. Aparasu, Hua Chen, Michael L. Johnson, Marc Labaron Fleming

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective. Prescription drug abuse has reached epidemic levels, leading to overdose-related morbidity and mortality. Patient and regional-level factors are believed to contribute to higher rates of prescription drug abuse. The objective of this study was to determine the prevalence and factors associated with multiple provider episodes (MPEs) in Texas. Methods. This was a retrospective cohort analysis of data from the Texas Prescription Drug Monitoring Program (PDMP) database, linked with Texas county census data. Descriptive statistics and a multilevel model regression analysis were employed to estimate the prevalence of MPEs and examine the association between individual controlled substance prescription (CSP) utilization and county factors associated with MPEs. Results. Among the 10,381,532 Texas residents utilizing CSPs in 2013, prescription opioids were the most frequently dispensed CSP (38.64%). The prevalence of MPEs was 71.30 per population of 100,000. Of those with MPEs, 76.98% received CSPs for more than 150 days and 11.48% had an average daily morphine equivalent dose (MED) 100 mg/day or higher. Residing in metropolitan areas, traveling more than 100 miles to obtain and fill prescriptions, chronic use of CSPs, younger age, and high MED were all significantly associated with increased risk of MPEs. Conclusions. This study revealed that previous estimates of prescription drug abuse may be drastically underestimated. Prescription drug abuse is a major public health problem in Texas, especially in metropolitan areas. Therefore, prevention efforts need to be addressed at the individual level and through public health and policy legislation.

Original languageEnglish
Pages (from-to)1941-1951
Number of pages11
JournalPain Medicine (United States)
Volume18
Issue number10
DOIs
StatePublished - 1 Oct 2017

Fingerprint

Prescription Drug Misuse
Prescription Drugs
Drug Monitoring
Prescriptions
Controlled Substances
Morphine
Public Health
Censuses
Public Policy
Health Policy
Legislation
Opioid Analgesics
Cohort Studies
Regression Analysis
Databases
Morbidity
Mortality
Population

Keywords

  • Controlled Substance Prescriptions (CSPs)
  • Multiple Provider Episodes (MPE)
  • Prescription Drug Monitoring Program (PDMP)
  • Prescription drug abuse
  • Prescription opioids

Cite this

Ferries, Erin A. ; Gilson, Aaron M. ; Aparasu, Rajendar R. ; Chen, Hua ; Johnson, Michael L. ; Fleming, Marc Labaron. / Prevalence and factors associated with multiple provider episodes in Texas : An epidemiological analysis of prescription drug monitoring program data. In: Pain Medicine (United States). 2017 ; Vol. 18, No. 10. pp. 1941-1951.
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abstract = "Objective. Prescription drug abuse has reached epidemic levels, leading to overdose-related morbidity and mortality. Patient and regional-level factors are believed to contribute to higher rates of prescription drug abuse. The objective of this study was to determine the prevalence and factors associated with multiple provider episodes (MPEs) in Texas. Methods. This was a retrospective cohort analysis of data from the Texas Prescription Drug Monitoring Program (PDMP) database, linked with Texas county census data. Descriptive statistics and a multilevel model regression analysis were employed to estimate the prevalence of MPEs and examine the association between individual controlled substance prescription (CSP) utilization and county factors associated with MPEs. Results. Among the 10,381,532 Texas residents utilizing CSPs in 2013, prescription opioids were the most frequently dispensed CSP (38.64{\%}). The prevalence of MPEs was 71.30 per population of 100,000. Of those with MPEs, 76.98{\%} received CSPs for more than 150 days and 11.48{\%} had an average daily morphine equivalent dose (MED) 100 mg/day or higher. Residing in metropolitan areas, traveling more than 100 miles to obtain and fill prescriptions, chronic use of CSPs, younger age, and high MED were all significantly associated with increased risk of MPEs. Conclusions. This study revealed that previous estimates of prescription drug abuse may be drastically underestimated. Prescription drug abuse is a major public health problem in Texas, especially in metropolitan areas. Therefore, prevention efforts need to be addressed at the individual level and through public health and policy legislation.",
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Prevalence and factors associated with multiple provider episodes in Texas : An epidemiological analysis of prescription drug monitoring program data. / Ferries, Erin A.; Gilson, Aaron M.; Aparasu, Rajendar R.; Chen, Hua; Johnson, Michael L.; Fleming, Marc Labaron.

In: Pain Medicine (United States), Vol. 18, No. 10, 01.10.2017, p. 1941-1951.

Research output: Contribution to journalArticle

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T1 - Prevalence and factors associated with multiple provider episodes in Texas

T2 - An epidemiological analysis of prescription drug monitoring program data

AU - Ferries, Erin A.

AU - Gilson, Aaron M.

AU - Aparasu, Rajendar R.

AU - Chen, Hua

AU - Johnson, Michael L.

AU - Fleming, Marc Labaron

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N2 - Objective. Prescription drug abuse has reached epidemic levels, leading to overdose-related morbidity and mortality. Patient and regional-level factors are believed to contribute to higher rates of prescription drug abuse. The objective of this study was to determine the prevalence and factors associated with multiple provider episodes (MPEs) in Texas. Methods. This was a retrospective cohort analysis of data from the Texas Prescription Drug Monitoring Program (PDMP) database, linked with Texas county census data. Descriptive statistics and a multilevel model regression analysis were employed to estimate the prevalence of MPEs and examine the association between individual controlled substance prescription (CSP) utilization and county factors associated with MPEs. Results. Among the 10,381,532 Texas residents utilizing CSPs in 2013, prescription opioids were the most frequently dispensed CSP (38.64%). The prevalence of MPEs was 71.30 per population of 100,000. Of those with MPEs, 76.98% received CSPs for more than 150 days and 11.48% had an average daily morphine equivalent dose (MED) 100 mg/day or higher. Residing in metropolitan areas, traveling more than 100 miles to obtain and fill prescriptions, chronic use of CSPs, younger age, and high MED were all significantly associated with increased risk of MPEs. Conclusions. This study revealed that previous estimates of prescription drug abuse may be drastically underestimated. Prescription drug abuse is a major public health problem in Texas, especially in metropolitan areas. Therefore, prevention efforts need to be addressed at the individual level and through public health and policy legislation.

AB - Objective. Prescription drug abuse has reached epidemic levels, leading to overdose-related morbidity and mortality. Patient and regional-level factors are believed to contribute to higher rates of prescription drug abuse. The objective of this study was to determine the prevalence and factors associated with multiple provider episodes (MPEs) in Texas. Methods. This was a retrospective cohort analysis of data from the Texas Prescription Drug Monitoring Program (PDMP) database, linked with Texas county census data. Descriptive statistics and a multilevel model regression analysis were employed to estimate the prevalence of MPEs and examine the association between individual controlled substance prescription (CSP) utilization and county factors associated with MPEs. Results. Among the 10,381,532 Texas residents utilizing CSPs in 2013, prescription opioids were the most frequently dispensed CSP (38.64%). The prevalence of MPEs was 71.30 per population of 100,000. Of those with MPEs, 76.98% received CSPs for more than 150 days and 11.48% had an average daily morphine equivalent dose (MED) 100 mg/day or higher. Residing in metropolitan areas, traveling more than 100 miles to obtain and fill prescriptions, chronic use of CSPs, younger age, and high MED were all significantly associated with increased risk of MPEs. Conclusions. This study revealed that previous estimates of prescription drug abuse may be drastically underestimated. Prescription drug abuse is a major public health problem in Texas, especially in metropolitan areas. Therefore, prevention efforts need to be addressed at the individual level and through public health and policy legislation.

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KW - Prescription Drug Monitoring Program (PDMP)

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KW - Prescription opioids

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