Abstract
Chronic opioid use is associated with adverse effects on the gastrointestinal (GI) tract and increased morbidity.1-3 Despite efforts to de-escalate opioid use, 10% of outpatient GI visits are associated with an opioid prescription.4 Although we previously described declining opioid prescriptions to Medicare patients by most gastroenterologists,5 opioid prescriptions for GI conditions have increased.4 Considerable variation in opioid prescribing behavior exists in the general physician population, and a small percentage of high prescribers are responsible for driving opioid prescriptions.6,7 The aims of this study are (1) to examine the impact of high opioid prescribers (HPs) on overall prescription volume in gastroenterology and (2) identify characteristics associated with HPs.
Highlights
Chronic opioid use is associated with adverse effects on the gastrointestinal (GI) tract and increased morbidity.[1,2,3] Despite efforts to de-escalate opioid use, 10% of outpatient GI visits are associated with an opioid prescription.[4]
Gastroenterologists in our study were designated as a high opioid prescribers (HPs) for a given year if their opioid prescription volume was in the 90th percentile
We previously found that most gastroenterologists are modest prescribers of opioids,[5] our results highlight the widespread influence of a small number of HPs
Summary
Chronic opioid use is associated with adverse effects on the gastrointestinal (GI) tract and increased morbidity.[1,2,3] Despite efforts to de-escalate opioid use, 10% of outpatient GI visits are associated with an opioid prescription.[4]. Our study population was comprised of United States gastroenterologists with at least one Medicare opioid prescription between 2013 and 2017. For each gastroenterologist in our database, we categorized their practice settings as either academic or community and practice area in 1 of 4 categories: advanced endoscopy, hepatology, inflammatory bowel disease (IBD), or general gastroenterology.
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