TY - JOUR
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 L.
N1 - Publisher Copyright:
© 2017 American Academy of Pain Medicine.
PY - 2017/10/1
Y1 - 2017/10/1
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.
KW - Controlled Substance Prescriptions (CSPs)
KW - Multiple Provider Episodes (MPE)
KW - Prescription Drug Monitoring Program (PDMP)
KW - Prescription drug abuse
KW - Prescription opioids
UR - http://www.scopus.com/inward/record.url?scp=85037598813&partnerID=8YFLogxK
U2 - 10.1093/pm/pnw250
DO - 10.1093/pm/pnw250
M3 - Article
C2 - 27744401
AN - SCOPUS:85037598813
SN - 1526-2375
VL - 18
SP - 1941
EP - 1951
JO - Pain Medicine (United States)
JF - Pain Medicine (United States)
IS - 10
ER -