The Association Between Doctor and Pharmacy Shopping and Self-Reported Misuse and Abuse of Prescription Opioids: A Survey Study
Received 25 September 2019
Accepted for publication 19 February 2020
Published 3 April 2020 Volume 2020:13 Pages 689—701
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Michael A Überall
Judith J Stephenson,1 M Soledad Cepeda,2 Jie Zhang,3,4 Jade Dinh,4 Kelsey Hall,4 Daina B Esposito,4– 6 David M Kern2
1Scientific Affairs, HealthCore, Inc, Wilmington, DE, USA; 2Epidemiology, Janssen Research and Development, Titusville, NJ, USA; 3Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA; 4Safety and Epidemiology, HealthCore, Inc., Wilmington, DE, USA; 5Ciconia, Inc, Westford, MA, USA; 6Epidemiology, Boston University, Boston, MA, USA
Correspondence: Judith J Stephenson
HealthCore, Inc., 123 Justison Street, Suite 200, Wilmington, DE 19801, USA
Tel +1 302-230-2142
Background/Rationale: Little is known about the reasons for visiting multiple doctors/pharmacies, known as doctor/pharmacy shopping, to obtain opioids.
Objective: To investigate patients’ self-reported reasons for doctor/pharmacy shopping and assess whether doctor/pharmacy shopping behavior can be used as a surrogate measure of opioid abuse/misuse.
Methods: We conducted a cross-sectional web-based survey among adult patients with ≥ 2 pharmacy claims for immediate-release or extended-release/long-acting opioids between 7/1/2015 and 12/31/2016, identified from a large United States (US) commercial claims database. Patients were classified into no, mild, moderate, or severe shopping categories based on their claims. Reasons for doctor/pharmacy shopping and opioid abuse/misuse were determined from patient responses to the Prescription Opioid Misuse and Abuse Questionnaire.
Results: A random sample of 10,081 patients was invited to participate in the survey and 1085 (11%) completed surveys. The most frequently reported reasons for doctor/pharmacy shopping were convenience, availability, price, and multiple morbidities requiring pain management. Among patients in the no, minimal, moderate, and severe shopping categories, only 7.8%, 8.5%, 11.8% and 12.6% reported opioid abuse/misuse, respectively.
Conclusion: In this commercially-insured population, patient-reported reasons for doctor/pharmacy shopping do not suggest opioid abuse/misuse. Less than 15% of patients with shopping behavior in the past 3 months reported any reasons attributable to opioid abuse/misuse, indicating that shopping behavior in this population may not be a good surrogate for abuse/misuse.
Keywords: doctor/pharmacy shopping, prescription opioid, abuse and misuse
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]