Distance Traveled and Frequency of Interstate Opioid Dispensing in Opioid Shoppers and Nonshoppers

Cepeda, M. Soledad; Fife, Daniel; Yuan, Yingli; Mastrogiovanni, Greg

doi:10.1016/j.jpain.2013.04.014

Cited by 34 publications

(38 citation statements)

References 9 publications

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“…[41][42][43] Poor data quality has been implicated as a barrier to the uptake of the programs. 44,45 PDMPs are statebased initiatives. Since not all states implement these programs, and because data are generally not shared among states, inter-state prescribing activities cannot be adequately captured.…”

Section: Discussionmentioning

confidence: 99%

Provider Patient-Sharing Networks and Multiple-Provider Prescribing of Benzodiazepines

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Provider Patient-Sharing Networks and Multiple-Provider Prescribing of Benzodiazepines

et al. 2015

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“…Thresholds used for identifying doctor shopping behavior vary greatly between studies but generally include prescriptions from more than one prescriber and/or filled at more than one pharmacy within a given window of time, anywhere from one to 18 months. 5,8,9,27 Some use highly restrictive criteria (eg, six or more prescribers and six or more pharmacies within 3 months) that benefit from specificity but likely underestimate the extent of the problem. 5 We examined a range of thresholds for doctor shopping behavior, ranging from four or more prescribers and four or more pharmacies within a 90-day period (4 × 4 × 90),…”

Section: Methodsmentioning

confidence: 99%

“…Patient‐to‐prescriber travel patterns may also be a useful indicator of potential misuse . A national study of opioid doctor shopping behavior found shoppers traveled greater distances than nonshoppers and more often crossed state borders to fill prescriptions . A study in Maine found increasing patient‐to‐prescriber travel distance was associated with increased relative odds of a prescriber being subject to severe disciplinary actions by the state medical board .…”

Section: Introductionmentioning

confidence: 99%

“…8 A national study of opioid doctor shopping behavior found shoppers traveled greater distances than nonshoppers and more often crossed state borders to fill prescriptions. 9 A study in Maine found increasing patient-to-prescriber travel distance was associated with increased relative odds of a prescriber being subject to severe disciplinary actions by the state medical board. 10 Here we introduce doctor hopping behavior, characterized by above average patient-to-prescriber travel distances and patients bypassing nearby prescribers in favor of more distant ones.…”

Section: Introductionmentioning

confidence: 99%

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Doctor hopping and doctor shopping for prescription opioids associated with increased odds of high‐risk use

Young

Hayes

Aram

et al. 2019

Pharmacoepidemiology and Drug

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Purpose Early detection of risky behaviors involving prescription opioids can assist prescribers in implementing safer prescribing. Patient‐to‐prescriber travel patterns may indicate potential opioid misuse. We introduce doctor hopping, patients bypassing nearby prescribers in favor of more distant ones, as a new spatial estimation of potentially risky behavior, and compare with traditional doctor shopping metrics. Methods We examined all filled opioid prescriptions between 2015 and 2016 from the Arkansas Prescription Drug Monitoring Program. We calculated patient‐to‐prescriber travel times and number of prescribers bypassed for each prescription, adjusted for payment method. Opioid recipients traveling further than the nearest urban area and bypassing more prescribers than 99% of other recipients from the same zip code were identified as doctor hoppers. We calculated odds ratios to evaluate how doctor hopping and doctor shopping correspond to high‐risk opioid uses. Results Approximately 0.72% of all opioid recipients in Arkansas engaged in doctor hopping two or more times during the study period. Rates of doctor hopping varied spatially but were more common in rural areas. Doctor shopping was more common in urban areas. Both hopping and shopping were significantly associated with higher odds of engaging in high‐risk opioid use. The combination of doctor hopping and doctor shopping metrics can predict high‐risk use better than either metric alone and may allow for earlier detection than doctor shopping alone. Conclusions Doctor hopping is positively associated with high‐risk opioid use and is distinct from and complementary to doctor shopping. We recommend Prescription Drug Monitoring Program (PDMP) vendors incorporate similar spatial analyses into their systems.

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“…These studies were based on calculations of daily dose that enabled detection of drug overdosing and monitoring the numbers of prescriptions written by different doctors [11,[14][15][16][17][18][19]. Some studies also included information on the number of pharmacies involved [20][21][22][23][24][25]. Clinical trials and surveys used definitions based on the number of visits during the same illness episode or for the same, often chronic, condition without or within a specified timeframe and without a professional referral.…”

Section: Definition Of Doctor-shoppingmentioning

confidence: 99%

Characteristics of doctor-shoppers: a systematic literature review

Biernikiewicz¹,

Taieb²,

Toumi

2019

Journal of Market Access & Health Policy

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Objective: Doctor-shopping has significant consequences for patients and payers and can indicate misuse of drugs, polypharmacy, less continuity of care, and increased medical expenses. This study reviewed the literature describing doctor-shoppers in the adult population. Methods: A systematic literature review was performed in PubMed and supplemented by a Google search of grey literature. Overall, 2885 records were identified; 43 papers served as a source of definition of a doctor-shopper, disease, treatment, patient characteristics, patient special needs, country. Results: Definitions of doctor-shopping were heterogeneous. Overall, 40% of studies examined the use of opioids, antidepressants, or psychoactive drugs, while the others focused on chronic or frequent diseases. Most studies were conducted in countries with easy access to healthcare resources (USA, France, Taiwan, Hong Kong). The prevalence of doctor-shopping ranged from 0.5% among opioid users in the USA to 25% of patients registered at general practices in Japan. Comorbidities, active substance abuse, greater distance from healthcare facility, younger age, longer disease and poor patient satisfaction increased doctor-shopping. Conclusions: Knowing the characteristics of doctor-shoppers may help identify such patients and reduce the associated waste of medical resources, but concerns about the misuse of drugs or healthcare resources should not prevent proper disease management.

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Distance Traveled and Frequency of Interstate Opioid Dispensing in Opioid Shoppers and Nonshoppers

Cited by 34 publications

References 9 publications

Provider Patient-Sharing Networks and Multiple-Provider Prescribing of Benzodiazepines

Provider Patient-Sharing Networks and Multiple-Provider Prescribing of Benzodiazepines

Doctor hopping and doctor shopping for prescription opioids associated with increased odds of high‐risk use

Characteristics of doctor-shoppers: a systematic literature review

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