Back to Search
Start Over
National opioid prescribing trends in emergency departments by provider type: 2005-2015.
- Source :
-
The American journal of emergency medicine [Am J Emerg Med] 2019 Aug; Vol. 37 (8), pp. 1439-1445. Date of Electronic Publication: 2018 Oct 22. - Publication Year :
- 2019
-
Abstract
- Purpose: To describe opioid prescribing practice patterns and trends in emergency department visits (EDs) by provider type: physicians and advanced practice providers (APPs), which include nurse practitioners (NPs) and physician assistants (PAs).<br />Methods: The data source was the ED visit files of the 2005-2015 National Hospital Ambulatory Care Survey. The study sample was opioid prescription-related ED visits. Descriptive and multinomial logistic regression analyses were conducted to assess the proportion of opioid prescription-related visits by provider type over time in total and by patient age group. We then characterized opioid prescribing practices of NPs, PAs, and physicians according to type of opioid and pain-related diagnosis.<br />Results: From 2005 to 2015, there was a 116.7% increase in the proportion of the opioid prescription-related visits seen by NPs and a 61.2% increase seen by both APPs and physicians. In contrast, the proportion of the physician-only visits decreased (-8.3%). When stratified by age group, the growth was particularly notable among the visits with patients aged 65 and older seen by both APPs and physicians (AOR = 2.35, 95% CI = 1.69, 3.25). Proportionally less hydromorphone and morphine was prescribed by APPs than by physicians. Opioids were prescribed more often by APPs in visits involving dental and injury-related pain, whereas physicians prescribed opioids more in abdominal and chest pain-related visits.<br />Conclusions: From 2005 to 2015, APPs, particularly NPs played an increasing role in opioid prescribing in EDs. Opioid prescribing practices of APPs and physicians varied by patient condition as well as by opioid type.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Health Care Surveys
Humans
Hydromorphone therapeutic use
Infant
Infant, Newborn
Logistic Models
Male
Middle Aged
Morphine therapeutic use
Nurse Practitioners statistics & numerical data
Physician Assistants statistics & numerical data
Physicians statistics & numerical data
United States
Young Adult
Analgesics, Opioid therapeutic use
Emergency Service, Hospital statistics & numerical data
Pain drug therapy
Practice Patterns, Physicians' statistics & numerical data
Practice Patterns, Physicians' trends
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8171
- Volume :
- 37
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- The American journal of emergency medicine
- Publication Type :
- Academic Journal
- Accession number :
- 30377010
- Full Text :
- https://doi.org/10.1016/j.ajem.2018.10.041