ArticleAddiction (Abingdon, England)2022
New means, new measures: assessing prescription drug-seeking indicators over 10 years of the opioid epidemic.
Article in Addiction (Abingdon, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictive Models to Assess Risk of Persistent Opioid Use, Opioid Use Disorder, and Overdose.Journal of addiction medicinePooled it
- Methylphenidate as a Novel Adjunct in Opioid-Taking Patients: Insights into Dopaminergic Neuroadaptation and Hypoactive Delirium.Brain sciences · 2025Review
- Social network analysis for medical narcotics in South Korea: focusing on patients and healthcare organizations.BMC health services research · 2024Article
- Opioid prescription patterns in the province of Las Palmas, Canary Islands, Spain (2016-2020): differences between urban and rural areas.Frontiers in pharmacology · 2023Article
- Comparing measures of centrality in bipartite patient-prescriber networks: A study of drug seeking for opioid analgesics.PloS one · 2022Article
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10 authors.
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Abstract
BACKGROUND AND
aimsPrescription drug-seeking (PDS) from multiple prescribers is a primary means of obtaining prescription opioids; however, PDS behavior has probably evolved in response to policy shifts, and there is little agreement about how to operationalize it. We systematically compared the performance of traditional and novel PDS indicators.
designLongitudinal study using a de-identified commercial claims database.
settingUnited States, 2009-18.
participantsA total of 318 million provider visits from 21.5 million opioid-prescribed patients. MEASUREMENTS: We applied binary classification and generalized linear models to compare predictive accuracy and average marginal effect size predicting future opioid use disorder (OUD), overdose and high morphine milligram equivalents (MME). We compared traditional indicators of PDS to a network centrality measure, PageRank, that reflects the prominence of patients in a co-prescribing network. Analyses used the same data and adjusted for patient demographics, region, SES, diagnoses and health services.
findingsThe predictive accuracy of a widely used traditional measure (N + unique doctors and N + unique pharmacies in 90 days) on OUD, overdose and MME decreased between 2009 and 2018, and performed no better than chance (50% accuracy) after 2015. Binarized PageRank measures however exhibited higher predictive accuracy than the traditional binary measures throughout 2009-2018. Continuous indicators of PDS performed better than binary thresholds, with days of Rx performing best overall with 77-93% predictive accuracy. For example, days of Rx had the highest average marginal effects on overdose and OUD: a 1 standard deviation increase in days of Rx was associated with a 6-8% [confidence intervals (CIs) = 0.058-0.061 and 0.078-0.082] increase in the probability of overdose and a 4-5% (CIs = 0.038-0.043 and 0.047-0.053) increase in the probability of OUD. PageRank performed nearly as well or better than traditional indicators of PDS, with predictive performance increasing after 2016.
conclusionsIn the United States, network-based measures appear to have increasing promise for identifying prescription opioid drug-seeking behavior, while indicators based on quantity of providers or pharmacies appear to have decreasing utility.
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