Rural/Urban Differences in the Predictors of Opioid Prescribing Rates Among Medicare Part D Beneficiaries 65 Years of Age and Older

Shoff, Carla; Yang, Tse Chuan; Kim, Seul-Ki

doi:10.1111/jrh.12497

Cited by 7 publications

(9 citation statements)

References 24 publications

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“…For example, fentanyl is the most frequently consumed opioid analgesic in many countries (García del Pozo et al 2008 ; Hamunen et al 2009 ; Hider-Mlynarz et al 2018 ), although Mordecai et al ( 2018 ) indicated that fentanyl was, by far, the least prescribed drug in primary care in England during 2010–2014. However, previous studies focused on describing how opioid prescription rates vary across country, region or province-municipal-level, or between rural and urban areas (Shoff et al 2021 ). Other authors have examined demographic and socioeconomic factors related to prescription opioid use in different countries (Bosetti et al 2019 ; Jarlbaek 2019 ; Pear et al 2019 ; Böckerman et al 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“…Other studies have shown that there are considerable differences in opioid-related measurements between rural and urban areas. The rural areas were found to have higher rates of opioid prescription, higher rates of high-dose opioid prescription, or fewer resources for inpatient and outpatient opioid treatment, etc., in comparison to urban areas (Keyes et al 2014 ; Sears et al 2020 ; Shoff et al 2021 ). Serdarevic et al ( 2017 ) suggest that older women, especially, those living alone, have higher rates of prescription opioid use.…”

Section: Introductionmentioning

confidence: 99%

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Opioid use trends in Spain: the case of the island of La Gomera (2016–2019)

Oliva

Armas

Dévora

et al. 2021

Naunyn-Schmiedeberg's Arch Pharmacol

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This study is an evaluation of prescription opioid use on the island of La Gomera, a mainly rural area, during the period 2016–2019 at various levels. Data were extracted from the wholesalers who supply the community pharmacies at the population level. Prescription opioid use was measured as defined daily doses per 1,000 inhabitants/day (DID) and by the number of units sold per 1,000 inhabitants and year (units sold). This provided an island total of La Gomera’s overall prescription of opioids and its rate of change, as well as differences in prescribing at the municipal and health area level. Tramadol with acetaminophen and tramadol in monotherapy were the most consumed by “units sold” parameter, which accounted for 69.48% and 18.59% of the total. The situation was similar for DID, although with lower percentages, but a significant increase was observed in the use of fentanyl and buprenorphine, around 15% in each case. The balance between the uses of weak or strong opioids was different in La Gomera compared to that of Spain as a whole. In Spain, almost 70% of the prescriptions were for weak opioids compared to 58.67% in La Gomera. Fentanyl was the most used strong opioid (16.10%) followed by tapentadol and buprenorphine, around 5% each, whereas in La Gomera, buprenorphine was the most consumed (15.75%) followed by fentanyl (14.87%) and tapentadol (5.82%). These differences in prescription opioid use are most likely explained by prescriber characteristics, whereas the population age, socioeconomic status, or living in rural/urban area are not decisive determinants.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Opioid use trends in Spain: the case of the island of La Gomera (2016–2019)

Oliva

Armas

Dévora

et al. 2021

Naunyn-Schmiedeberg's Arch Pharmacol

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“…This may be influenced by a higher prevalence of pain, specifically chronic and high‐impact chronic pain, in rural communities; 27 lower availability of other pain treatment modalities; 28 or other factors. 29 …”

Section: Discussionmentioning

confidence: 99%

“…This may be influenced by a higher prevalence of pain, specifically chronic and high-impact chronic pain, in rural communities; 27 lower availability of other pain treatment modalities; 28 or other factors. 29 Perhaps reflecting an overall decrease in access to or hesitance to use health care services, 30,31 days' supply of opioid prescriptions increased across schedules in both LBBA and HBBA counties during the EO active period. Although days' supply decreased in the health care reopening phase, the acute increase in days' supply is concerning because of associations with long-term opioid use.…”

Section: Discussionmentioning

confidence: 99%

“…Overall opioid prescribing rates are commonly higher in rural counties, 22–26 which made up 80.85% of LBBA counties versus 34.62% of HBBA counties in this study. This may be influenced by a higher prevalence of pain, specifically chronic and high‐impact chronic pain, in rural communities; 27 lower availability of other pain treatment modalities; 28 or other factors 29 …”

Section: Discussionmentioning

confidence: 99%

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Broadband internet subscription rates and opioid prescribing via telemedicine during the COVID‐19 pandemic

Oyler

Slavova

Freeman

et al. 2022

The Journal of Rural Health

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Purpose In response to the COVID‐19 pandemic, the US DEA allowed controlled substance prescriptions to be issued following a telemedicine encounter. This study evaluated changes in opioid prescribing in Kentucky counties with low and high rates of broadband subscription before, during, and after a series of statewide emergency declarations that may have affected health care access. Methods The study used the prescription drug monitoring program to analyze records of opioid analgesic prescriptions dispensed to opioid‐naïve individuals in high (N = 26) and low (N = 94) broadband access counties during 3 periods: before a state of emergency (SOE) and executive order (EO) limiting nonemergent health care services (January 2019‐February 2020), while the EO was active (March‐April 2020), and after health care services began reopening (May‐December 2020). Marginal generalized estimating equations‐type negative binomial models were fit to compare prescription counts by broadband access over the 3 periods. Findings Rates of opioid dispensing to opioid‐naïve individuals decreased significantly during the EO, but increased nearly to pre‐SOE levels after health care services began reopening. Dispensing rates in low broadband counties were higher than those in high broadband counties during all time periods, although these differences were negligible after adjusting for potential confounders. During the EO, prescriptions were written for longer days’ supply in both county types. Conclusions The overall dramatic reduction in opioid prescribing rates should be considered when evaluating annual opioid prescribing trends. However, broadband subscription rate did not appear to influence opioid prescriptions dispensed in Kentucky during the EO.

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Racial and ethnic differences in COVID-19 hospitalizations by metropolitan status among Medicare beneficiaries, 1 January–31 December 2020

Chang

Moonesinghe

Truman

2021

Journal of Public Health

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Background Risk for COVID-19 hospitalizations increases with increasing age and presence of underlying medical conditions. However, the burden has not been well-assessed in metropolitan and nonmetropolitan areas by race/ethnicity among Medicare population with chronic conditions. Methods We used the 2020 Medicare data to estimate COVID-19 hospitalization rates by race/ethnicity among Medicare beneficiaries for COVID-19 by metropolitan status and to assess the association of hospitalizations from COVID-19 with each of selected 29 chronic conditions for patients by metropolitan status and by race/ethnicity. Results The COVID-19 hospitalization rate was higher among beneficiaries residing in nonmetropolitan counties than those residing in metropolitan counties in 2020. Approximately 1 in 2 AI/AN, 1 in 3 NHB, Hispanic and A/PI, and 1 in 4 NHW beneficiaries with COVID-19 residing in nonmetropolitan counties were hospitalized. Beneficiaries with COVID-19 and chronic conditions were more likely to be hospitalized compared with those without chronic conditions. Conclusions Hospitalization rates among beneficiaries with COVID-19 and chronic conditions were not distributed equally by race/ethnicity and by metropolitan status. Researchers, policymakers and practitioners can use these findings to explore more effective ways of reducing racial/ethnic and geographic disparities among minorities disproportionately affected by COVID-19 and are at highest risk of hospitalization.

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Rural/Urban Differences in the Predictors of Opioid Prescribing Rates Among Medicare Part D Beneficiaries 65 Years of Age and Older

Cited by 7 publications

References 24 publications

Opioid use trends in Spain: the case of the island of La Gomera (2016–2019)

Opioid use trends in Spain: the case of the island of La Gomera (2016–2019)

Broadband internet subscription rates and opioid prescribing via telemedicine during the COVID‐19 pandemic

Racial and ethnic differences in COVID-19 hospitalizations by metropolitan status among Medicare beneficiaries, 1 January–31 December 2020

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