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An analysis of the number of multiple prescribers for opioids utilizing data from the California Prescription Monitoring Program
Author(s) -
Wilsey Barth L.,
Fishman Scott M.,
Gilson Aaron M.,
Casamalhuapa Carlos,
Baxi Hassan,
Lin TzuChun,
Li ChinShang
Publication year - 2011
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.2129
Subject(s) - medicine , medical prescription , pharmacoepidemiology , family medicine , aka , medical emergency , emergency medicine , nursing , library science , computer science
Background Prescription monitoring programs scrutinize the prescribing of controlled substances to diminish the utilization of multiple prescribers (aka. “doctor shopping”). The use of multiple prescribers is not a problem per se and can be legitimate, as when the patient's regular physician is not available or a concurrent painful condition is being cared for by a different practitioner. Purpose The primary objective of this study was to determine if those patients who used a few prescribers (two to five) in a 1‐year period were distinguishable from those who used only one prescriber. Methods We performed a secondary data analysis of the California Prescription Monitoring Program, the Controlled Substance Utilization Review and Evaluation System, by using data collected during 1999–2007. Results The group who used a few providers (two to five) differed substantially from those who visited one provider over a 1‐year period. However, the dissimilarity did not suggest that these patients were more prone to the abuse of opioids. Conclusions The decision not to investigate patients who visit a low number of multiple prescribers (two to five) appears to be justifiable. If the number of providers in a given period of time is used to determine if a patient should be challenged as being a “doctor shopper,” cutoffs with high specificity (low false‐positive rates) should be chosen. Further epidemiologic research is needed to determine the association of the number of prescribers and misuse and/or abuse of opioids. Copyright © 2011 John Wiley & Sons, Ltd.