Abstract
BackgroundRadiation oncologists (ROs) play an important role in managing cancer pain; however, their opioid prescribing patterns remain poorly described.MethodsThe 2016 Medicare Physician Compare National Downloadable and the 2016 Medicare Part D Prescriber Data files were cross‐linked to identify RO‐written opioid prescriptions.ResultsOf 4,627 identified ROs, 1,360 (29.3%) wrote >10 opioid prescriptions. The average number of opioid prescriptions written was significantly (P ≤ .05) associated with the following RO characteristics: sex [13.1 ± 36.5 male vs 7.5 ± 16.9 female]; years since medical school graduation [4.5 ± 11.5 1‐10 years vs 12.6 ± 26.0 11‐24 years vs 13.3 ± 40.9 ≥25 years]; practice size [15.5 ± 44.6 size ≤10 vs 13.3 ± 25.9 size 11‐49 vs 8.5 ± 12.7 size 50‐99 vs 8.8 ± 26.9 size ≥100]; Medicare Physician Quality Reporting System (PQRS) participation [12.6 ± 31.8 yes vs 7.0 ± 35.4 no]; and practice location [17.4 ± 47.0 South vs 10.6 ± 29.4 Midwest vs 8.1 ± 13.9 West vs 6.9 ± 15.2 Northeast]. On multivariable regression modeling, male sex (RR 1.29, 95% CI 1.22‐1.35, P < .001), ≥25 years since graduation (RR 0.78, 95% CI 0.64‐0.70, 1‐10 years vs ≥25 years; RR 1.00, 95% CI 0.96 ‐ 1.04, 11‐24 years vs ≥25 years; P < .001), practice size <10 members (RR 1.51, CI 1.44‐1.59, ≤10 vs ≥100 members, RR 1.27, CI 1.20‐1.34, 10‐49 vs ≥100 members, RR 0.86, CI 0.80‐0.92, 50‐99 vs ≥100 members, P < .001), PQRS participation (RR 1.12, CI 1.04‐1.19, P < .002), and Southern location (RR 0.67, CI 0.64‐0.70, Midwest vs South; RR 0.39, CI 0.37‐0.41, Northeast vs South; RR 0.43, CI 0.41‐0.46, West vs South; P < .001) were predictive of higher opioid prescription rates.ConclusionsFactors associated with increased number of RO‐written opioid prescriptions were male sex, ≥25 years since graduation, group practice <10, PQRS participation, and Southern location. Additional research is required to establish optimal opioid prescribing practices for ROs.
Highlights
In 2017, the Department of Health and Human Services declared the opioid crisis in the United States (US) a national emergency
2,850 (61.6%) Radiation oncologists (ROs) wrote at least one opioid prescription (Figure 1)
Among ROs who prescribed an opioid at least once, the average number of opioid prescriptions written increased to 18.8 ± 39.8
Summary
The average number of opioid prescriptions written was significantly (P ≤ .05) associated with the following RO characteristics: sex [13.1 ± 36.5 male vs 7.5 ± 16.9 female]; years since medical school graduation [4.5 ± 11.5 1-10 years vs 12.6 ± 26.0 11-24 years vs 13.3 ± 40.9 ≥25 years]; practice size [15.5 ± 44.6 size ≤10 vs 13.3 ± 25.9 size 11-49 vs 8.5 ± 12.7 size 50-99 vs 8.8 ± 26.9 size ≥100]; Medicare Physician Quality Reporting System (PQRS) participation [12.6 ± 31.8 yes vs 7.0 ± 35.4 no]; and practice location [17.4 ± 47.0 South vs 10.6 ± 29.4 Midwest vs 8.1 ± 13.9 West vs 6.9 ± 15.2 Northeast]. Conclusions: Factors associated with increased number of RO-written opioid prescriptions were male sex, ≥25 years since graduation, group practice
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