Opioid-Prescribing Patterns of Emergency Physicians and Risk of Long-Term Use: Evidence from Medicare and Private Insurers

In 2015, over 20,000 Americans died of an overdose related to prescription pain relievers; approximately 1 person every 26 minutes. A study recently published in the New England Journal of Medicine highlights the correlation between emergency department prescribing practices and long-term prescription pain reliever use in Medicare patients.

The research team from the Harvard T. H. Chan School of Public Health conducted a retrospective study of the Part D medical records of almost 400,000 Medicare beneficiaries who visited an emergency department between 2008 and 2011 and had not received an opiate prescription in the 6 months prior to the visit. They found that emergency department prescribing practices varied widely even within the same hospital, and that patients treated by high-intensity prescribers were significantly more likely to continue long-term use of prescription opioids over the next 12 months.

The research team behind the study notes that the findings may not be generalizable outside Medicare patients. Dr. Kit Delgado, an Assistant Professor in Emergency Medicine at the University of Pennsylvania Perelman School of Medicine, is a current CHERISH pilot grant awardee who is studying physician-level variability in prescription opioid prescribing practices for six specific diagnoses across multiple specialties using national private insurance claims. He commented, “We’ve seen similar variation in opioid prescribing on a visit level and a state-level among private insurers, which has increased the number of pills entering the community and resulted in excess cost to the health system.” Dr. Delgado will present his findings at the Society for Academic Emergency Medicine on May 17, 2017.