TITLE:
Opioid Prescriptions in Women: Is the Data Accurate?
AUTHORS:
Keren Khromchenko, Jonathan D. Baum
KEYWORDS:
Centers for Disease Control and Prevention (CDC), Medicaid, New Jersey, New Jersey Prescription Monitoring Program (NJPMP), Opioid(s), Prescription, Private Insurance, Reproductive
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.9,
September
15,
2022
ABSTRACT: Background: In 2012, U.S. health care providers wrote more than 259 million opioid
prescriptions, which is twice as many as in 1998. Approximately 1 in 10 women report the use of opioids for pain management during pregnancy. The Centers for
Disease Control and Prevention (CDC) estimated that between 2008 and 2012, 39%
of reproductive-aged women on Medicaid had filled a prescription for opioid
medication each year, as did 28% of women with private insurance. The opioid
epidemic extends to the state of New Jersey (NJ); however, limited data is available regarding opioid prescriptions among
Medicaid and private insurance patients within the state. Objective: Evaluate
opioid prescriptions filled in reproductive-aged women presenting in labor at a
community teaching hospital in suburban New Jersey.Methods: We performed a retrospective cohort study using data obtained
from patient records and the New Jersey Prescription Monitoring Program (NJPMP)
database. We enrolled 200 patients that were admitted in labor between May 2015
and May 2016. Data was collected from reproductive-aged women during the one
year preceding labor admission. We compared our findings to national data
reported by the CDC using Chi-square analysis. Maternal demographic data were
extracted from patient records and included age, insurance status (private
insurance, Medicaid, and no insurance), race, and ethnicity. The primary
outcome was opioid prescriptions filled. Results: Of the 200 women admitted in labor, 129 had private insurance, 63 had
Medicaid, and 8 had no insurance. We found that 5.4% (7/129) of patients with private insurance, 4.8% (3/63) of patients
with Medicaid, and 12.5% (1/8) of patients with no insurance filled opioid
prescriptions. Overall, 5.5% (11/200) of women filled opioid prescriptions
during the study period. Opioid prescriptions
confirmed via NJPMP were significantly lower than rates reported by the CDC in
Medicaid (4.8% vs. 41.4%, p-value 0.001)
and private insurance (5.4% vs. 29.1%, p-value Conclusion: Rates of opioid prescriptions filled were
lower among our suburban cohort of women in New Jersey than national rates
reported by the CDC. We did not confirm that patients with Medicaid filled more
prescriptions than patients with private insurance. These discrepancies raise
the question of whether a federal prescription monitoring program would better
capture data than state-wide programs. Further research is needed to ensure
that prescription monitoring programs are actually capturing accurate data.