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Changes in early high‐risk opioid prescribing practices after policy interventions in Washington State
Author(s) -
Sears Jeanne M.,
Haight John R.,
FultonKehoe Deborah,
Wickizer Thomas M.,
Mai Jaymie,
Franklin Gary M.
Publication year - 2021
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13564
Subject(s) - medicine , opioid , medical prescription , population , psychological intervention , pharmacy , emergency medicine , family medicine , environmental health , psychiatry , nursing , receptor
Objective To test associations between several opioid prescribing policy interventions and changes in early (acute/subacute) high‐risk opioid prescribing practices. Data Sources Population‐based workers' compensation pharmacy billing and claims data, Washington State Department of Labor and Industries (January 2008‐June 2015). Study Design We used interrupted time series analysis to test associations between three policy intervention timepoints and monthly proportions of population‐based measures of high‐risk, low‐risk, and any workers’ compensation‐related opioid prescribing. We also tested associations between the policy intervention timepoints and five high‐risk opioid prescribing indicators among workers prescribed any opioids within 3 months after injury: (a) >7 cumulative (not necessarily consecutive) days‘ supply of opioids during the acute phase, (b) high‐dose opioids, (c) concurrent sedatives, (d) chronic opioids, and (e) a composite high‐risk opioid prescribing indicator. Principal Findings Within 3 months after injury, 9 percent of workers were exposed to high‐risk and 12 percent to low‐risk workers’ compensation‐related opioid prescribing; 79 percent filled no workers’ compensation‐related opioid prescription. Among workers prescribed any early (acute/subacute) opioids, the indicator for >7 days' supply of opioids during the acute phase was present for 30 percent, high‐dose opioids for 18 percent, concurrent sedatives for 3 percent, and chronic opioids for 2 percent. Beyond a general shift toward more infrequent and lower‐risk workers’ compensation‐related opioid prescribing, each policy intervention timepoint was significantly associated with reductions in specific acute/subacute high‐risk opioid prescribing indicators; each of the four specific high‐risk opioid prescribing indicators had significant reductions associated with at least one policy. Conclusions Several state‐level opioid prescribing policies were significantly associated with safer workers’ compensation‐related opioid prescribing practices during the first 3 months after injury (acute/subacute phase), which should in turn reduce transition to chronic opioids and associated negative health outcomes.