Opioid Prescribing Behavior of Interventional Radiologists Across the United States |
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| Affiliation: | 1. Department of Radiology, NYU Langone Medical Center, New York, New York;2. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;3. Harvey L. Neiman Health Policy Institute, Reston, Virginia;4. School of Economics, Georgia Institute of Technology, Atlanta, Georgia;1. Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas;2. Department of Radiology, Mayo Clinic, Rochester, Minnesota;3. Department of Radiology, Ochsner Clinic Foundation and The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, Louisiana;1. Nvidia Corporation, Santa Clara, California;2. The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland;1. Department of Radiology, University Hospitals Case Medical Center, Cleveland, OH 44106;2. Department of Hematology/Oncology, University Hospitals Case Medical Center, Cleveland, OH 44106;3. Department of Urology, University Hospitals Case Medical Center, Cleveland, OH 44106;4. Case Western Reserve University School of Medicine, 2109 Adelbert Road, Cleveland, OH 44106;5. Case Western Reserve University, 2109 Adelbert Road, Cleveland, OH 44106;6. The Centers for Dialysis Care, Shaker Heights, Ohio;1. Center for Research on Utilization of Imaging Services (CRUISE), Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania;2. HealthHelp, Inc, Houston, Texas |
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| Abstract: | PurposeTo study opioid prescribing behavior of US interventional radiologists (IRs).MethodsUsing Medicare Physician and Other Supplier Public Use File claims, we identified 2,133 radiologists whose practice in 2015 comprised predominantly interventional radiology. Cross-linking the Medicare Part D Prescriber File, their opioid prescription writing behavior was characterized.ResultsMost (52.2%) IRs wrote 10 or fewer prescriptions total for Medicare beneficiaries. Of the 47.8% who wrote >10 prescriptions, 87.4% prescribed an opioid, most commonly hydrocodone with acetaminophen, at least once (71.3%, 1-10 opioid prescriptions; 27.4%, 11-100; 1.3%, ≥101). Overall, 23.0% of all prescriptions by those IRs writing >10 were for opioids, with an average 8.0-day prescription. Average opioid prescriptions per IR were significantly (P ≤ .015) independently associated with their providing clinical evaluation and management (E&M) services (9.7 opioid prescriptions per IR with demonstrable E&M encounters versus 2.2 if not), practice size (12.6 for practices with ≤ 10 members versus 3.7-4.8 for larger groups), and geography (8.3 in the South versus 3.6-4.0 elsewhere). Rates were highest in Georgia (39.5) and lowest in Delaware (2.0). Higher opioid prescribing rates showed additional univariable associations with more years in practice and nonacademic practices.ConclusionMost IRs write few, if any, prescriptions for Medicare beneficiaries. Of those who do, the large majority writes for opioids, at rates higher than national physician benchmarks. IRs’ opioid prescribing varies significantly based on physician and practice characteristics and particularly whether the IR provides clinical E&M services. In light of the nation’s opioid epidemic, these observations may guide education, practice improvement, and policy efforts to optimize opioid prescribing. |
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| Keywords: | Opioids interventional radiology Medicare prescriptions health policy |
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