Public Health and Primary CareORIGINAL ARTICLE

Associations of clinical personnel characteristics and controlled substance prescribing practices

Robert Millhollon, BS; Covenant Elenwo, MPH; Alex Lundberg, BS; Will Roberts, DO; Jason Beaman, DO; Natasha Bray, DO; and Micah Hartwell, PhD
Notes and Affiliations
Notes and Affiliations

Received: November 27, 2022

Accepted: March 24, 2023

Published: May 3, 2023

  • Robert Millhollon, BS, 

    Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA

  • Covenant Elenwo, MPH, 

    Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA

  • Alex Lundberg, BS, 

    Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA

  • Will Roberts, DO, 

    Department of Anesthesia, Oklahoma State University Medical Center, Tulsa, OK, USA

  • Jason Beaman, DO, 

    Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA

  • Natasha Bray, DO, 

    Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA

  • Micah Hartwell, PhD, 

    Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA

J Osteopath Med; 123(9): 451-458
Abstract

Context: Over 68,000 deaths were attributed to opioid-related overdose in 2020. Evaluative studies have shown that states that utilized Prescription Drug Monitoring Program (PDMP) systems have decreased opioid-related deaths. With the growing use of PDMPs and an ongoing opioid epidemic, determining the demographics of physicians at risk of overprescribing can elucidate prescribing practices and inform recommendations to change prescribing behaviors.

Objectives: This study aims to assess prescribing behaviors by physicians in 2021 based on four demographics utilizing the National Electronic Health Record System (NEHRS): physician’s age, sex, specialty, and degree (MD or Doctor of Osteopathic Medicine [DO]).

Methods: We performed a cross-sectional study of the 2021 NEHRS to determine the relationship between physician characteristics and PDMP use on opioid-prescribing behaviors. Differences between groups were measured via design-based chi-square tests. We constructed multivariable logistic regression models to assess the relationships, via adjusted odds ratios (AOR), between physician characteristics and alternate prescribing patterns.

Results: Compared to female physicians, male physicians were more likely to alter their original prescription to reduce morphine milligram equivalents (MMWs) prescribed for a patient (AOR: 1.60; CI: 1.06–2.39; p=0.02), to change to a nonopioid/nonpharmacologic option (AOR: 1.91; 95 % CI: 1.28–2.86; p=0.002), to prescribe naloxone (AOR=2.06; p=0.039), or to refer for additional treatment (AOR=2.07; CI: 1.36–3.16; p<0.001). Compared to younger physicians, those over the age of 50 were less likely to change their prescription to a nonopioid/nonpharmacologic option (AOR=0.63; CI: 0.44–0.90; p=0.01) or prescribe naloxone (AOR=0.56, CI: 0.33–0.92; p=0.02).

Conclusions: Our results showed a statistically significant difference between specialty category and frequency of prescribing controlled substances. After checking the PDMP, male physicians were more likely to alter their original prescription to include harm-reduction strategies. Optimizing the use of PDMP systems may serve to improve prescribing among US physicians.

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