Some new information
Planned hypothesis generating analysis of a larger survey on opioid prescribing, fielded by state licensing authority in Nov 2019.
- Setting: All DEA-registered Kentucky (US) physicians.
- Outcome: Physician characteristics, opioid prescribing
- Analysis: Descriptive univariable/bivariable stats Emails were delivered to 7631 physicians, with 651 respondents (8.5% - similar to other unincentivized physician surveys). After limiting to controlled substance prescribers and removing incommpletes, the analysis sample was n=349.
When making prescribing decisions regarding which opioid analgesic to prescribe, do you consider whether or not the opioid is an abuse-deterrent formulation?
In general, please indicate the primary reason you have prescribed OxyContin®.
Full analysis of early adopter prescribers.
Exposure
Self-reported affirmation of any of 3 statements: I prescribe new medications before others; I enjoy the variety of prescribing new medicines; I like to share with colleagues about new medicines I've prescribed. (Other options: I feel more comfortable using familiar medications, etc.).
The analysis sample was n=349, with 83 (24%) early prescribers. Early adopters were disproportionately in early or late career (less than 15 or 35+ practice-years). The male:female ratio was 2:1 among respondents, but proportionately more females (26%) than males (19%) were early adopters. There were no differences in patient load, practice setting, or medical specialty except emergency medicine and general surgery were less likely; and oncology and OB/GYN were more likely to be early adopters.
Early prescribers were more likely to use opioid risk stratification tools (OR 1.5; 0.85, 2.7). Abuse deterrent formulation (ADF) opioid prescribing was similar (OR 1.1; 0.65, 1.8). However, early adopters were more likely (OR 1.4; 0.73, 2.6) to prescribe newer non-OxyContin ADFs, with 93% endorsing "innovative nature of abuse-deterrence mechanisms" as a consideration. They supported legislation mandating insurance coverage for ADFs (OR 3.5; 1.6, 8.9), and more strongly endorsed technical solutions like electronic prescription monitoring programs and urine drug screens, while opposing prescribing limits.