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Affected person, Prescriber, and Group Components Related to Stuffed Naloxone Prescriptions Amongst Sufferers Receiving Buprenorphine 2017–18


Background

Prescribing naloxone to sufferers at elevated opioid overdose threat is a key part of opioid overdose prevention efforts, however little is understood about naloxone fills amongst sufferers receiving buprenorphine for opioid use dysfunction, one such excessive threat group.

Strategies

This retrospective cross-sectional research used de-identified pharmacy claims representing 90% of all prescriptions crammed at retail pharmacies in 50 states and the District of Columbia. We carried out a multivariable logistic regression to look at crammed naloxone prescriptions amongst sufferers receiving buprenorphine remedy and assessed how crammed naloxone prescriptions fluctuate by affected person, prescriber, and group traits.

Outcomes

Stuffed naloxone prescriptions occurred amongst 4.5% of buprenorphine remedy episodes. Episodes paid by way of Medicaid (aOR 2.40, 95%CI 2.33–2.47) and Medicare (aOR 1.53, 95%CI 1.46–1.60) had increased odds of crammed naloxone prescriptions than business insurance coverage episodes. In comparison with episodes the place the first prescriber was an grownup main care doctor, odds of filling a naloxone prescription had been increased amongst episodes prescribed by dependancy specialists (aOR 1.30, 95% CI 1.24–1.37) and doctor assistants/nurse practitioners (aOR 1.57, 95% CI 1.53–1.61).

Conclusions

Prescribing naloxone to sufferers receiving buprenorphine represents a tangible medical motion that may be taken to assist stop opioid overdose deaths. Nonetheless, regardless of suggestions to co-prescribe naloxone to sufferers at elevated threat for opioid overdose, charges of filling naloxone prescriptions stay low amongst sufferers disbursed buprenorphine. States, insurers, and well being techniques ought to contemplate implementing methods to facilitate elevated co-prescribing of naloxone to at-risk people.

This report is a part of the RAND Company exterior publication sequence. Many RAND research are revealed in peer-reviewed scholarly journals, as chapters in business books, or as paperwork revealed by different organizations.

The RAND Company is a nonprofit establishment that helps enhance coverage and decisionmaking by way of analysis and evaluation. RAND’s publications don’t essentially mirror the opinions of its analysis purchasers and sponsors.

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