For Medicare beneficiaries, concurrent opioid prescribing is common among those with four or more opioid providers, according to a study published in BMJ (2014;348:g1393).

Anupam B. Jena, MD, PhD, from Harvard Medical School in Boston, and colleagues extracted information from a database of prescription drugs and medical claims in a 20% random sample of Medicare beneficiaries. The authors sought to estimate the frequency and characteristics of opioid prescribing by multiple providers in Medicare in 2010.

The researchers found that 34.6% of the 1,208,100 beneficiaries with an opioid prescription filled prescriptions from two providers, 14.2% from three providers, and 11.9% from four or more providers. More than three-quarters (77.2%) of beneficiaries with four or more providers received concurrent opioid prescriptions from multiple providers, with the dominant provider prescribing about half of the mean total (7.9/15.2 prescriptions).

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The highest multiple provider prescribing was seen among beneficiaries who were also prescribed stimulants; non-narcotic analgesics; and central nervous system, neuromuscular, and antineoplastic drugs. Opioid use-related hospital admissions increased with multiple provider prescribing, with annual unadjusted admission rates of 1.63%, 2.08%, 2.87%, and 4.83% for beneficiaries with one, two, three, and four or more providers, respectively.

“Concurrent opioid prescribing by multiple providers is common in Medicare patients and is associated with higher rates of hospital admission related to opioid use,” the researchers concluded.