Abstract
Purpose: Increased opioid analgesic prescribing (OAP) has been associated with increased risk of prescription opioid diversion, misuse, and abuse. We studied regional and rural-urban variations in OAP trends in Kentucky, from 2012 to 2015, and examined potential county-level risk and protective factors. Methods: This study used prescription drug monitoring data. Marginal models employing generalized estimating equations were used to model repeated counts of residents with opioid analgesic prescriptions within county-quarter, 2012–2015, with offset for resident population, by rural-urban classification exposure, and adjusting for time-varying socioeconomic and relevant health status measures. Findings: There were significant downward trends in rates of residents receiving dispensed opioid analgesic prescriptions, with no regional or rural/urban differences in the degree of decline over time. The adjusted models showed the Kentucky Appalachian region retained a significantly higher rate of residents with opioid analgesic prescriptions per 1,000 residents (30% higher than Central Kentucky and 19% higher than Kentucky Delta regions). Residents of nonmetropolitan not adjacent-to-metropolitan counties had significantly higher adjusted rates of OAP (33% higher than metropolitan counties and 17% higher compared to nonmetropolitan adjacent-to-metropolitan counties). The rate of OAP was significantly positively associated with emergency department visit injury rates and negatively associated with buprenorphine/naloxone prescribing rates. Conclusions: Information on OAP trends and patterns will be used by Kentucky stakeholders to inform targeted interventions. Further research is needed to evaluate the availability and accessibility of nonopioid pain treatment in rural counties and the role of geography and time/distance traveled as risk factors for increased OAP.
| Original language | English |
|---|---|
| Pages (from-to) | 97-107 |
| Number of pages | 11 |
| Journal | Journal of Rural Health |
| Volume | 35 |
| Issue number | 1 |
| DOIs | |
| State | Published - Dec 1 2019 |
Bibliographical note
Funding Information:Funding: This project was supported by Grant No. 2014-PM-BX-0010 (Data-Driven Multidisciplinary Approaches to Reducing Prescription Abuse in Kentucky) awarded by the Bureau of Justice Assistance (BJA) to the Kentucky Injury Prevention and Research Center as bona fide agent for the Kentucky Department for Public Health. The BJA is a component of the Department of Justice’s Office of Justice Program, which includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office of Victims Crime, and the SMART Office. Viewpoints or opinions in this document are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Justice.
Funding Information:
The authors would like to thank Dr. Terry Bunn and Dr. Julia Costich from the Kentucky Injury Prevention and Research Center for their comments and review. The authors acknowledge the members of the Kentucky All Schedule Prescription Electronic Reporting (KASPER) staff with the Kentucky Cabinet for Health and Family Services for their support of this project. This project was supported by Grant No. 2014-PM-BX-0010 (Data-Driven Multidisciplinary Approaches to Reducing Prescription Abuse in Kentucky) awarded by the Bureau of Justice Assistance (BJA) to the Kentucky Injury Prevention and Research Center as bona fide agent for the Kentucky Department for Public Health.
Publisher Copyright:
© 2018 National Rural Health Association
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
Keywords
- PDMP
- buprenorphine
- opioid prescribing
- regional variation
- rural-urban
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
