Douglas C. McDonald, PhD, and Kenneth E. Carlson, from Abt Associates Inc. in Cambridge, MA, examined the prevalence of doctor shopping to obtain multiple opioid prescriptions and the amounts and types of opioids involved. Records were reviewed for 146.1 million opioid prescriptions dispensed by 76 percent of U.S. retail pharmacies during 2008. Prescriptions were linked to unique patients.
The researchers found that patients in the extreme outlying population (0.7 percent of purchasers), who were thought to be doctor shoppers, obtained 32 prescriptions for opioids from 10 different prescribers, on average. This group purchased 1.9 percent of all opioid prescriptions, constituting 4 percent of the total weighed amounts that were dispensed.
"To close the information gap that makes doctor shopping and uncoordinated care possible, states have created prescription drug monitoring programs to collect records of scheduled drugs dispensed, but the majority of physicians do not access this information," the authors write. "To facilitate use by busy practitioners, most monitoring programs should improve access and response time, scan prescription data to flag suspicious purchasing patterns, and alert physicians and pharmacists."
The authors are employees of Abt Associates Inc., a commercial scientific research company.