Stanford study: 30% of opioid-naive Medicaid patients develop a dependency after prescription

Healthcare suppliers want higher algorithms to foretell opioid dependency, particularly amongst Medicaid sufferers, in response to new analysis from Stanford College and Gainwell.

Stanford researchers teamed up with healthcare expertise firm Gainwell to make use of the corporate’s datasets —  180,000 de-identified Medicaid claims from six states (three within the Southeast, two within the West and one within the Midwest). Their analysis revealed that amongst sufferers who had by no means taken an opioid, 30% developed an opioid dependency following their first prescription. The research was printed final week in PLOS Digital Well being.

The analysis exhibits {that a} affected person’s first expertise receiving an opioid prescription is an important issue that may result in opioid dependancy, stated Tina Hernandez-Boussard, a professor on the Stanford College Faculty of Drugs and the research’s lead writer, in an interview. Prescription amount and length are the 2 most vital components which might be predictive of opioid dependency, she added.

There are additionally sure opioids which might be extra related to dependence, in response to the research. Prescriptions for tramadol, typically offered below the model identify ConZip or Ultram, in addition to long-acting oxycodone had been discovered to have probably the most dependancy threat. 

“Danger components will not be at all times intuitive, as a result of I feel intuitively lots of people would assume that the shorter-acting opioids could be extra prone to misuse,” stated Gary Name, Gainwell’s chief medical officer. “That’s form of how we ended up with the opioid disaster. When the lengthy appearing ones had been first marketed, they had been purported to be much less vulnerable to abuse.”

This discovering can also be fascinating as a result of tramadol has been traditionally marketed as a “secure” opioid that may be much less addictive than others, Hernandez-Boussard identified. Neither Sanofi nor Janssen — each notable manufactures of the drug — responded to requests for remark.

Each Hernandez-Boussard and Name agreed that the objective of this analysis is to advance precision drugs by fascinated by what predictive threat algorithms will be utilized to opioid prescribing going ahead, particularly amongst susceptible Medicaid populations. 

“A lot of the opioids analysis that we see being printed is from educational medical facilities’ personal insurance coverage sufferers, who may need completely different wants and completely different ranges of threat,” Hernandez-Boussard declared. “Medicaid is mostly a susceptible inhabitants the place we don’t actually know whether or not we have to deal with them otherwise for ache administration.”

Gainwell will use the research’s findings to develop new care administration and predictive modeling merchandise to foretell opioid dependancy threat, Name stated. The corporate is designing these algorithms to account for social determinants of well being, looking for to establish opioid-naive sufferers who’re at increased threat of opioid dependency. 

As soon as the instruments are developed, it’s Gainwell’s hope that they’ll assist suppliers grow to be extra conscious of the doable penalties of long-acting or high-quantity opioid prescriptions, probably main them to rethink the forms of opioids they prescribe to opioid-naive Medicaid sufferers. These threat predictors can be used to flag sufferers who may have academic outreach concerning the hazard of opioid dependancy and the way to safely adhere to their therapy plan, Name stated.

Gainwell’s growth of those algorithms comes because the opioid disaster has exacerbated additional — overdoses are actually the main explanation for injury-related loss of life within the U.S. Throughout the 12-month interval that resulted in April 2021, greater than 100,000 People died from drug overdoses, in response to knowledge from the Facilities for Illness Management and Prevention. Of these deaths, about three-quarters concerned opioids.

Photograph: VladimirSorokin, Getty Pictures

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