Medical oncologists in the United States have been writing fewer prescriptions for opioids in recent years, according to a study presented at the NCCN 2023 Annual Conference.
The study showed that opioid prescribing rates decreased significantly in 2017. This was a year after the Centers for Disease Control and Prevention updated its guidelines for opioid prescribing in noncancer settings and the same year the federal government designated the opioid crisis a public health emergency, said one of the study presenters, Joseph G. Santitoro, a medical student at Rutgers New Jersey Medical School in Newark.
For this study, Santitoro and colleagues analyzed data from the Centers for Medicare & Medicaid Services. The researchers assessed opioid prescribing practices by medical oncologists during 2013-2019. The number of oncologists evaluated each year ranged from 9349 in 2013 to 10,047 in 2017.
Opioid prescribing rates were similar from 2013 through 2016. In 2017, however, prescribing rates were significantly lower than rates in 2013 (odds ratio [OR], 0.929; 95% CI, 0.869-0.994; P <.05).
This decreasing trend was maintained in 2018 (OR, 0.831; 95% CI, 0.776-0.890; P <.05) and 2019 (OR, 0.715; 95% CI, 0.667-0.766; P <.05), relative to 2013.
Prescribing practices differed significantly by region. Compared with the Midwest, oncologists in the South prescribed more opioids (OR, 1.639; 95% CI, 1.566-1.715; P <.05).
Oncologists in US territories (OR, 0.200; 95% CI, 0.140-0.283; P <.05), the Northeast (OR, 0.362; 95% CI, 0.340-0.386; P <.05), and the West (OR, 0.660; 95% CI, 0.623-0.699; P <.05) prescribed fewer opioids than oncologists in the Midwest.
Male oncologists dispensed more opioids than female oncologists (OR, 1.752; 95% CI, 1.678-1.829; P <.05). Oncologists in practice for 11 years or more dispensed more opioids than oncologists who were in their first decade of practice (OR range, 1.689-2.503; all P <.05).
Oncologists in urban settings dispensed fewer opioids than those in large rural settings (OR, 0.670; 95% CI, 0.623-0.721; P <.05). There were no significant differences between large rural settings and small town/rural settings or suburban settings.
“Future endeavors of our study include characterizing patient factors associated with higher numbers of opioid prescriptions in medical oncology as well as characterizing opioid prescribing trends before and after the onset of the COVID-19 pandemic,” Santitoro said.
Korst MR, Teles MS, Choudhry HS, Santitoro JG, Kra JA. Characterizing opioid prescribing trends of medical oncologists from 2013-2019. NCCN 2023. March 31-April 2, 2023. Abstract BPI23-007.