One in three American seniors who benefit from the U.S. Medicare program, receives painkiller prescription from several healthcare service providers, putting themselves at risk of drug overdose that could lead to injury and even death.
In a new study published in the British Medical Journal Feb.19, researchers analyzed the medical records of more than one million Medicare patients who have received opioid prescription in 2010. Opioid is a type of narcotic used for treating moderate to severe pain that does not respond to other forms of medication. Examples of opioid drugs include hydrocodone, fentanyl, morphine and oxycodone.
The researchers have found that 34.6 percent of the 1, 208,100 Medicare beneficiaries with an opioid prescription have received prescription from two doctors; more than 14 percent from three doctors; and almost 12 percent from four or more.
"We don't know if this is due to doctor shopping in those who have become addicted to these opioids, but this probably accounts for just a small fraction of what we're seeing," said study author Anupam Jena, an assistant professor of Health Care Policy and Medicine at Harvard Medical School.
The researchers also found that patients who receive their prescription from more than one doctor are more at risk of opioid-related hospitalization than patients who get their prescription from a single provider. They also noted that the risks went up with the number of prescribers showing a strong correlation between opioid-related hospitalizations and the number of prescribers.
"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," said study co-author Pinar Karaca-Mandic, an assistant professor at University of Minnesota School of Public Health.
The researchers have likewise called for healthcare service providers to educate their patients. "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," Jena said.
The researchers concluded that prescription of opioids by multiple providers is prevalent among Medicare beneficiaries and called for better monitoring of prescription drugs to curb the practice.
"Despite its limitations, our study suggests that concurrent prescribing of opioids by multiple providers is common among Medicare beneficiaries and is associated with higher rates of hospital admissions related to use," the researchers wrote. "Education of patients about the risks of obtaining prescription opioids from multiple providers, combined with enhancement of state efforts to monitor prescription drugs that allow access by providers to prescription databases at the point of care might be useful in curbing this practice."
