IADR Abstract Archives
Trajectories of Opioid Prescribing by Dentists and OMFS in the US
Objectives: Opioid prescribing by dentists and oral and maxillofacial surgeons (OMFS) has decreased, yet some still prescribe at high rates. Our objective was to identify high prescribers by defining trajectories of opioid prescribing.
Methods: The IQVIA Longitudinal Prescription dataset identified actively prescribing dentists and OMFS (≥20 prescriptions of any medication) from 2015-2019. Group-based trajectory models (GBTM) identified opioid prescribing trajectories based on annual prescribing rates (number of opioids/total number of prescriptions*100). Chi-square or Mann–Whitney U tests identified significant differences in characteristics by trajectory group.
Results: From 2015-2019, 2,741,030 opioids were prescribed by 199,145 dentists/OMFS. GBTM identified 8 groups of prescribers. In group 1 (14.3% of prescribers), opioids composed <1% of all prescriptions. Groups 2, 3 and 4 (15.2%, 17.7% and 13.0% of prescribers, respectively) prescribed at low rates (2015=5.5%, 12.5% and 16.9%; 2019=1.5%, 4.4% and 11.9%, respectively). Group 5 (7.9% of prescribers) decreased prescribing by 82.7% (2015=29.4%; 2019=5.1%). Groups 6 and 7 (16.3% and 12.1% of prescribers) prescribed opioids at moderate rates (2015=28.7% and 39.2%; 2019=18.1% and 28.8%, respectively). Group 8 (3.5% of prescribers) consistently prescribed at high rates (2015=54.6%; 2019=44.7%). Within this high group, 4 trajectories were identified; 3 groups did not change their prescribing while 1 group (7.5% of high prescribers) rapidly declined prescribing. Compared with a combination of the 3 groups, the decliner group had more dentists (85.4% vs 80.8%) and fewer OMFS (13.0% vs 18.4%). At baseline, decliners had more Medicaid patients (2.5% vs 1%) and a higher opioid prescribing rate (95.5 vs 91.6 prescriptions/provider/100 patients, p<0.001 for all).
Conclusions: GBTM identified consistently high opioid prescribers; a few high prescribers significantly decreased prescribing. Understanding characteristics of the decliners can inform future opioid stewardship interventions.
Methods: The IQVIA Longitudinal Prescription dataset identified actively prescribing dentists and OMFS (≥20 prescriptions of any medication) from 2015-2019. Group-based trajectory models (GBTM) identified opioid prescribing trajectories based on annual prescribing rates (number of opioids/total number of prescriptions*100). Chi-square or Mann–Whitney U tests identified significant differences in characteristics by trajectory group.
Results: From 2015-2019, 2,741,030 opioids were prescribed by 199,145 dentists/OMFS. GBTM identified 8 groups of prescribers. In group 1 (14.3% of prescribers), opioids composed <1% of all prescriptions. Groups 2, 3 and 4 (15.2%, 17.7% and 13.0% of prescribers, respectively) prescribed at low rates (2015=5.5%, 12.5% and 16.9%; 2019=1.5%, 4.4% and 11.9%, respectively). Group 5 (7.9% of prescribers) decreased prescribing by 82.7% (2015=29.4%; 2019=5.1%). Groups 6 and 7 (16.3% and 12.1% of prescribers) prescribed opioids at moderate rates (2015=28.7% and 39.2%; 2019=18.1% and 28.8%, respectively). Group 8 (3.5% of prescribers) consistently prescribed at high rates (2015=54.6%; 2019=44.7%). Within this high group, 4 trajectories were identified; 3 groups did not change their prescribing while 1 group (7.5% of high prescribers) rapidly declined prescribing. Compared with a combination of the 3 groups, the decliner group had more dentists (85.4% vs 80.8%) and fewer OMFS (13.0% vs 18.4%). At baseline, decliners had more Medicaid patients (2.5% vs 1%) and a higher opioid prescribing rate (95.5 vs 91.6 prescriptions/provider/100 patients, p<0.001 for all).
Conclusions: GBTM identified consistently high opioid prescribers; a few high prescribers significantly decreased prescribing. Understanding characteristics of the decliners can inform future opioid stewardship interventions.