Use of Opioid Agonist Therapy for Medicare Patients in 2013

Lembke, Anna; Chen, Jonathan

doi:10.1001/jamapsychiatry.2016.1390

Cited by 39 publications

(30 citation statements)

References 5 publications

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“…Thus, if physicians prescribed buprenorphine to 13 patients on average, about 57 525 patients in 2010 and 103 116 patients in 2015 could have received the medication. This estimate is consistent with a prior study, which found that 6707 physicians prescribed buprenorphine to 81 000 of the 300 000 Medicare Part D enrollees with OUD in 2013 . Our findings suggest that if physicians prescribed buprenorphine closer to the 30 patient limit, the OUD treatment gap could be significantly reduced.…”

Section: Discussionsupporting

confidence: 91%

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County‐level access to opioid use disorder medications in medicare Part D (2010‐2015)

Abraham

Adams

Bradford

et al. 2019

Health Services Research

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Objective To identify geographic disparities in access to opioid use disorder (OUD) treatment medications and county demographic and economic characteristics associated with access to buprenorphine and oral naltrexone prescribers in Medicare Part D. Data Sources/Study Setting We utilized data from the Medicare Part D Prescription Drug Event Standard Analytic File (2010‐2015). Study Design/Data Collection We used logistic regression to examine county‐level access to OUD medication prescribers. Principal Findings There was a 5.6 percentage point increase in counties with access to an OUD prescriber over the study period. However, in 2015, 60 percent of US counties lacked access to a Medicare Part D buprenorphine prescriber and over 75 percent lacked access to an oral naltrexone prescriber. Increased access to OUD prescribers was largely concentrated in urban counties. Results of logistic regression indicate regional differences and potential racial disparities in access to OUD prescribers. Conclusions To improve access to buprenorphine and naltrexone treatment for Medicare Part D enrollees, CMS may consider implementing educational and training initiatives focused on OUD treatment, offering training to obtain a buprenorphine waiver at no cost to providers, and sending targeted information to providers in low OUD treatment capacity areas.

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Section: Discussionsupporting

confidence: 91%

“…Only one prior study examined the use of buprenorphine in the Medicare population . Results showed that there were 6707 buprenorphine prescribers in 2013, which represented less than 2 percent of the 381575 prescribers of schedule II opioid painkillers.…”

Section: Introductionmentioning

confidence: 99%

County‐level access to opioid use disorder medications in medicare Part D (2010‐2015)

Abraham

Adams

Bradford

et al. 2019

Health Services Research

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“…17,27,28 Estimates range, but suggest that only 20%–40% of people with OUDs are receiving MAT. 17,29,30 …”

Section: Introductionmentioning

confidence: 99%

Policy Pathways to Address Provider Workforce Barriers to Buprenorphine Treatment

Haffajee

Bohnert

Lagisetty

2018

American Journal of Preventive Medicine

190

167

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“…Opiate use has become increasingly common in older adults . The Medicare population has one of the highest and fastest‐growing rates of diagnosed opioid use disorder, with more than 6 of every 1,000 beneficiaries diagnosed a year . In 2014, the Centers for Disease Control and Prevention added opioid overdose prevention to its list of top five public health challenges …”

mentioning

confidence: 99%

Opiate Prescribing in Hospitalized Older Adults: Patterns and Outcomes

Maiti

Sinvani

Pisano

et al. 2017

J American Geriatrics Society

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Background/Objectives Whereas opiate prescribing patterns have been well described in outpatient and emergency department settings, they have been less defined in hospitalized older adults. The objective was to describe patterns of opiate prescribing and associated outcomes in hospitalized older adults. Design Retrospective cohort study. Setting Tertiary care facility. Participants Hospitalized medical patients aged 65 and older (N = 9,245; mean age 80.3, 55.2% female, 72.3% white, 90.8% non‐Hispanic). Measurements Opiate exposure and duration of action, concurrent use of potentially inappropriate medications (PIMs), adverse events, discharge disposition, length of stay (LOS), and 30‐day readmissions. Results There was no difference in sex, race, ethnicity, or Charlson Comorbidity Index between opiate exposure groups. Participants who had never received opiates had a significantly shorter mean LOS than prior and new opiate users (5.2, 6.8, 7.7 days; P < .001) and were more likely to be discharged home (88.6%, 82.8%, 82.5%; P < .001) and significantly less likely to be readmitted within 30‐days (19.6%, 25.0%, 22.3%; P < .001). Participant who had never been exposed to opiates had a significantly shorter mean LOS than those receiving short‐ and long‐acting opiates (5.2, 7.3, 8.6 days; P < .001) and were more likely to be discharged home (88.6%, 82.6%, 82.4%; P < .001) and significantly less likely to be readmitted within 30‐days (19.6%, 27.7%, 28.9%; P < .001). Conclusion Opiate use is widespread during hospitalization and is associated with significant negative clinical outcomes and quality metrics. There is an urgent need to develop innovative pain management alternatives to opiate use.

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Use of Opioid Agonist Therapy for Medicare Patients in 2013

Cited by 39 publications

References 5 publications

County‐level access to opioid use disorder medications in medicare Part D (2010‐2015)

County‐level access to opioid use disorder medications in medicare Part D (2010‐2015)

Policy Pathways to Address Provider Workforce Barriers to Buprenorphine Treatment

Opiate Prescribing in Hospitalized Older Adults: Patterns and Outcomes

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