Minority of dermatologists prescribe majority of opioids

 

Opioid prescribing among dermatologists is concentrated among a relative few, with surgeons and those in Southern states overrepresented, according to a study of Medicare Part D data for 2014.

“A small number of dermatologists account for a large percentage of the prescriptions. And it’s concentrated among dermatology surgeons, who are likely giving a standard prescription for a 4-day course of opioids after surgery,” senior author Arash Mostaghimi, MD, the director of inpatient services in the dermatology department at Brigham and Women’s Hospital, Boston, said in a press release issued by the hospital.

The investigators identified 12,537 dermatologists in the Part D Opioid Prescriber Summary File for 2014, of whom 42.3% had prescribed no opioid claims, 43.1% had prescribed 1-10 opioid claims, and 14.5% had prescribed more than 10. That 14.5% (about 1,800 dermatologists) prescribed more than 91,000 claims for opioids, and the top 1% (n = 115) of that group accounted for more than 42% of those prescriptions, Dr. Mostaghimi and his associates reported in JAMA Dermatology.

A closer look at those 115 top prescribers shows that 108, or 94%, worked in a surgical practice, 72% were located in Southern states, and 86% were male. Among all the dermatologists in the study, those in the South also had an opioid prescribing rate (2.77 claims/1,000 Medicare beneficiaries) that was more than triple the rate in the Northeast (0.83 claims/1,000 beneficiaries), the investigators said.

These prescriptions from dermatologists in 2014 potentially put more than 7,000 Medicare patients at risk for long-term opioid use, they noted, and may have created, based on consumption habits after Mohs microsurgery, a reservoir of more than 490,000 unused pills “that poses a substantial risk for future misuse.”

The study was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences. The investigators did not report any conflicts of interest.

[email protected]

SOURCE: Cao S et al. JAMA Dermatol. 2018 Feb 7. doi: 10.1001/jamadermatol.2017.5835.

 

Opioid prescribing among dermatologists is concentrated among a relative few, with surgeons and those in Southern states overrepresented, according to a study of Medicare Part D data for 2014.

“A small number of dermatologists account for a large percentage of the prescriptions. And it’s concentrated among dermatology surgeons, who are likely giving a standard prescription for a 4-day course of opioids after surgery,” senior author Arash Mostaghimi, MD, the director of inpatient services in the dermatology department at Brigham and Women’s Hospital, Boston, said in a press release issued by the hospital.

The investigators identified 12,537 dermatologists in the Part D Opioid Prescriber Summary File for 2014, of whom 42.3% had prescribed no opioid claims, 43.1% had prescribed 1-10 opioid claims, and 14.5% had prescribed more than 10. That 14.5% (about 1,800 dermatologists) prescribed more than 91,000 claims for opioids, and the top 1% (n = 115) of that group accounted for more than 42% of those prescriptions, Dr. Mostaghimi and his associates reported in JAMA Dermatology.

A closer look at those 115 top prescribers shows that 108, or 94%, worked in a surgical practice, 72% were located in Southern states, and 86% were male. Among all the dermatologists in the study, those in the South also had an opioid prescribing rate (2.77 claims/1,000 Medicare beneficiaries) that was more than triple the rate in the Northeast (0.83 claims/1,000 beneficiaries), the investigators said.

These prescriptions from dermatologists in 2014 potentially put more than 7,000 Medicare patients at risk for long-term opioid use, they noted, and may have created, based on consumption habits after Mohs microsurgery, a reservoir of more than 490,000 unused pills “that poses a substantial risk for future misuse.”

The study was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences. The investigators did not report any conflicts of interest.

[email protected]

SOURCE: Cao S et al. JAMA Dermatol. 2018 Feb 7. doi: 10.1001/jamadermatol.2017.5835.

 

Opioid prescribing among dermatologists is concentrated among a relative few, with surgeons and those in Southern states overrepresented, according to a study of Medicare Part D data for 2014.

“A small number of dermatologists account for a large percentage of the prescriptions. And it’s concentrated among dermatology surgeons, who are likely giving a standard prescription for a 4-day course of opioids after surgery,” senior author Arash Mostaghimi, MD, the director of inpatient services in the dermatology department at Brigham and Women’s Hospital, Boston, said in a press release issued by the hospital.

The investigators identified 12,537 dermatologists in the Part D Opioid Prescriber Summary File for 2014, of whom 42.3% had prescribed no opioid claims, 43.1% had prescribed 1-10 opioid claims, and 14.5% had prescribed more than 10. That 14.5% (about 1,800 dermatologists) prescribed more than 91,000 claims for opioids, and the top 1% (n = 115) of that group accounted for more than 42% of those prescriptions, Dr. Mostaghimi and his associates reported in JAMA Dermatology.

A closer look at those 115 top prescribers shows that 108, or 94%, worked in a surgical practice, 72% were located in Southern states, and 86% were male. Among all the dermatologists in the study, those in the South also had an opioid prescribing rate (2.77 claims/1,000 Medicare beneficiaries) that was more than triple the rate in the Northeast (0.83 claims/1,000 beneficiaries), the investigators said.

These prescriptions from dermatologists in 2014 potentially put more than 7,000 Medicare patients at risk for long-term opioid use, they noted, and may have created, based on consumption habits after Mohs microsurgery, a reservoir of more than 490,000 unused pills “that poses a substantial risk for future misuse.”

The study was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences. The investigators did not report any conflicts of interest.

[email protected]

SOURCE: Cao S et al. JAMA Dermatol. 2018 Feb 7. doi: 10.1001/jamadermatol.2017.5835.