Overuse raises risk for hospitalization, study finds
By Robert Preidt
WEDNESDAY, Feb. 19, 2014 (HealthDay News) -- About one-third of Medicare patients who get prescriptions for powerful narcotic painkillers receive them from multiple doctors, which raises their risk for hospitalization, according to a new study.
Narcotics (also called opioids) include painkillers such as hydrocodone (Vicodin), oxycodone (Oxycontin) and morphine. Prescriptions for these drugs have risen sharply in the United States in the past 20 years -- as have overdoses.
"As physicians, we tell patients not to drive when they take opioids, but we also need to tell them that it can be dangerous to receive these medications from more than one provider," said study author Dr. Anupam Jena, an assistant professor of health care policy at Harvard Medical School.
Jena and his colleagues also found that having multiple doctors prescribe prescription painkillers increased patients' risk of being hospitalized for drug-related complications such as breathing problems, drowsiness and injuries from falls.
For the study, which was published Feb. 19 in the journal BMJ, the researchers analyzed data from 1.8 million people enrolled in Medicare's prescription benefit (Part D) who filled at least one narcotic prescription in 2010. Medicare is the taxpayer-supported insurance program for the elderly.
The researchers said they were surprised to find that 30 percent of the patients were prescribed narcotic painkillers by more than one doctor.
"I thought it would be 5 percent to 10 percent," Jena said in a Harvard news release.
The greater the number of prescribers, the higher the risk of hospitalization, said study co-author Pinar Karaca-Mandic, an assistant professor at the University of Minnesota School of Public Health.
"Patients with four or more prescribers were twice as likely to be hospitalized for narcotics-related complications than patients receiving the same number of prescriptions from a single caregiver," Karaca-Mandic said in the news release.
Doctors need to inform patients about the risks associated with receiving painkillers from more than one health care provider, Jena said.
Many health systems and state governments are creating tools to make it easier for doctors to determine if patients are already getting prescription painkillers from another doctor.
Prescriptions for narcotics in the United States increased nearly three-fold from 1991 to 2009, to more than 200 million a year, according to the National Institutes of Health. Narcotic overuse and abuse is a major health issue in the country.
The American Academy of Family Physicians has more about opioids.
SOURCE: Harvard Medical School, news release, Feb. 19, 2014
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