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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 7 of 7 Research Studies DisplayedFeder SL, Canavan ME, Wang S
Patterns of opioid prescribing among Medicare Advantage beneficiaries with pain and cardiopulmonary conditions.
This study’s objective was to compare patterns of opioid prescribing among older adults reporting pain with cardiopulmonary conditions, cancer, or both. Data from the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey resource linked to Medicare Part D prescription claims was used to identify patients who self-reported moderate- to-severe pain interference with daily activities. Patients included were stratified by 1) self-reported history of cardiopulmonary conditions; 2) were within five years of cancer diagnosis; 3) had both conditions; or 4) neither. Of 10,516 patients identified, 1758 had cardiopulmonary conditions, 3383 cancer, 2861 both, and 2514 neither: with 46% aged 75 or more, 65% non-Hispanic white, and 10% non-Hispanic black. At the time of the survey, 1627 (15.5%) received opioids. Adjusted proportions of opioid use were similar for all conditions, with 14% for cardiopulmonary conditions only, 17% with cancer only, and 17% for both conditions. Patients with neither condition had a 13.1% opioid use rate.
AHRQ-funded; HS022882; HS025164.
Citation: Feder SL, Canavan ME, Wang S .
Patterns of opioid prescribing among Medicare Advantage beneficiaries with pain and cardiopulmonary conditions.
J Palliat Med 2021 Feb;24(2):195-204. doi: 10.1089/jpm.2020.0193..
Keywords: Elderly, Opioids, Medication, Practice Patterns, Medicare
Romman AN, Hsu CM, Chou LN
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
This study looked at trends in opioid prescribing frequency to Medicare Part D enrollees from 2013 to 2017 by medical specialty and provider type. The authors analyzed opioid claims and prescribing trends for specialties accounting for ≥1% of all opioid claims. Pain management specialists increased Medicare Part D opioid claims by 27.3% to 1,140 mean claims per provider in 2017. Physical medicine and rehabilitation providers increased claims by 16.9% to 511 mean claims per provider in 2017. All other medical specialties decreased opioid claims during this period, with emergency medicine decreasing the most (-19.9%) and orthopedic surgery (-16%) dropping opioid claims the most of all the other specialties. Overall physician decrease was -5.2%. However opioid claims among dentists (+5.6%) and nonphysician providers (+10.2%) increased during this period.
AHRQ-funded; HS020642.
Citation: Romman AN, Hsu CM, Chou LN .
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
Pain Med 2020 Nov 7;21(7):1400-07. doi: 10.1093/pm/pnz344..
Keywords: Elderly, Opioids, Medication, Medicare, Pain, Chronic Conditions, Practice Patterns
Hartung DM, Johnston K, Geddes J
Buprenorphine coverage in the Medicare Part D program for 2007 to 2018.
This letter discusses a study which looked into coverage of buprenorphine for opioid use disorder (OUP) with Medicare. The majority of plans do cover the generic version. However, the number of plans which require previous authorization has increased over from 2007 to 2018. This may hamper treatment by primary care physicians.
AHRQ-funded; HS024227.
Citation: Hartung DM, Johnston K, Geddes J .
Buprenorphine coverage in the Medicare Part D program for 2007 to 2018.
JAMA 2019 Feb 12;321(6):607-09. doi: 10.1001/jama.2018.20391..
Keywords: Health Insurance, Medicare, Medication, Opioids, Substance Abuse
Zhang Y, Johnson P, Jeng PJ
First opioid prescription and subsequent high-risk opioid use: a national study of privately insured and Medicare Advantage adults.
This study examined the association between a first opioid prescription and high-risk opioid use in the 18 months following the first prescription. A retrospective cohort study was conducted using data from a large commercial insurance claims database for patients aged 18-64 and also Medicare Advantage patients aged 65 or older for 2011-2014. The patients initially had not used opioids. The features the researchers were looking for were: 1) opioid or benzodiazepine prescriptions overlapping 7 days or more, 2) opioid prescriptions overlapping for 7 days or more; 3) three or more prescribers of opioids; and 4) a daily dosage exceeding 120 morphine milligram equivalents, in each of the six quarters following the first prescription. All of those features were strongly associated with high-risk use.
AHRQ-funded; HS021531.
Citation: Zhang Y, Johnson P, Jeng PJ .
First opioid prescription and subsequent high-risk opioid use: a national study of privately insured and Medicare Advantage adults.
J Gen Intern Med 2018 Dec;33(12):2156-62. doi: 10.1007/s11606-018-4628-y..
Keywords: Opioids, Substance Abuse, Medication, Risk, Medicare, Health Insurance
Axeen S
Trends in opioid use and prescribing in Medicare, 2006-2012.
The purpose of this study was to determine characteristics and trends in opioid use, questionable use, and prescribing in Medicare. The investigators conducted a retrospective analysis of a 20 percent sample of Medicare claims data. Estimates were adjusted using multivariable regression analysis. They found that opioid utilization and prescribing were increasingly heterogeneous from 2006 to 2012.
AHRQ-funded; HS024251.
Citation: Axeen S .
Trends in opioid use and prescribing in Medicare, 2006-2012.
Health Serv Res 2018 Oct;53(5):3309-28. doi: 10.1111/1475-6773.12846..
Keywords: Medicare, Medication, Opioids, Practice Patterns
Kuo YF, Raji MA, Liaw V
Opioid prescriptions in older Medicare beneficiaries after the 2014 federal rescheduling of hydrocodone products.
The authors sought to examine how an October 2014 Drug Enforcement Administration policy reclassified hydrocodone product from schedule III to II has affected older adults. They found that the 2014 change in hydrocodone from schedule III to schedule II was associated with modest decreases in rates of opioid use in the elderly. They also found an unexpected increase in opioid-related hospitalizations without documented opioid prescriptions, which may represent an increase in illegal use.
AHRQ-funded; HS022134.
Citation: Kuo YF, Raji MA, Liaw V .
Opioid prescriptions in older Medicare beneficiaries after the 2014 federal rescheduling of hydrocodone products.
J Am Geriatr Soc 2018 May;66(5):945-53. doi: 10.1111/jgs.15332.
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Keywords: Elderly, Medicare, Opioids, Policy, Practice Patterns
Kuo YF, Raji MA, Chen NW
Trends in opioid prescriptions among Part D Medicare recipients From 2007 to 2012.
The researchers used national Medicare data from 2007-2012 to assess temporal and geographic trends in rates of opioid prescription and relationship to opioid toxicity and different state regulations in Part D Medicare recipients. Their analyses of the Medicare data demonstrated substantial growth in opioid prescriptions from 2007 to 2011 and large variation in opioid prescriptions across states.
AHRQ-funded; HS022134.
Citation: Kuo YF, Raji MA, Chen NW .
Trends in opioid prescriptions among Part D Medicare recipients From 2007 to 2012.
Am J Med 2016 Feb;129(2):221.e21-30. doi: 10.1016/j.amjmed.2015.10.002..
Keywords: Chronic Conditions, Elderly, Medicare, Medication, Opioids, Pain