Concomitant Use of Opioids and Psychotropic Medications in Mississippi Medicaid Beneficiaries
Author(s)
Arabshomali A1, Eriakha O2, Lin LY1, Bhattacharya K3, Pittman E4, Bentley J4, Pearson M5, Lambert AK5, Smith EA5, Hubanks J5, Smith D6, Ramachandran S4
1Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA, 2Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, MS, USA, 3Department of Pharmacy Administration and Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, MS, USA, 4Department of Pharmacy Administration and Center for Pharmaceutical Marketing and Management, School of Pharmacy, University of Mississippi, University, MS, USA, 5Mississippi State Department of Health, Jackson, MS, USA, 6Mississippi Division of Medicaid, Jackson, MS, USA
Presentation Documents
OBJECTIVES: The aim of this project was to estimate the prevalence and intensity of concomitant use of opioids and psychotropic medications (co-use) in Mississippi Medicaid.
METHODS: Mississippi Medicaid administrative claims data were analyzed for each calendar year from 2016 to 2021. Eligible individuals consisted of Medicaid beneficiaries who filled at least one prescription for opioid analgesics. Psychotropic medications included antidepressants, benzodiazepines, antipsychotics, anticonvulsants, muscle relaxants, and non-benzodiazepine hypnotics. Study measures were the prevalence & intensity of co-use and average morphine equivalent daily dose (MEDD). Individual demographic characteristics (i.e., age, sex, race, county of residence) as well as the diagnosis of chronic non-cancer pain (CNCP) and use of long-term opioid therapy (LTOT) were identified.
RESULTS: The eligible sample ranged from 82,550 in 2016 to 51,583 in 2021. Among these eligible individuals, the presence of CNCP diagnoses ranged from 21% (2016) to 24% (2021) and use of LTOT ranged from 16% (2016) to 9% (2021). Average MEDD ranged from 45.6 (SD: 64.7) in 2016 to 40.6 (SD: 59.9) in 2021. The presence of at least one day of co-use was identified in approximately one-third of eligible individuals. Antidepressants, anticonvulsants, and muscle relaxants were the most commonly co-used, followed by benzodiazepines, non-benzodiazepine hypnotics, and antipsychotics. The intensity of co-use (co-use days/total opioid prescription days) ranged from 76.7% (SD: 30.7) in 2016 to 84.3% (SD: 26.7) in 2021. Overall, trends in medication use over time showed decreasing patterns of opioid prescribing, and LTOT, but relatively stable rates of concomitant psychotropic medication use in this population (with the exception of benzodiazepines, which showed a decreasing trend). Co-use intensity slightly increased over time.
CONCLUSIONS: Co-use is fairly common among Medicaid beneficiaries using opioid medications. Results suggest a potentially growing reliance on psychotropic medications for pain management, warranting further investigation about the safety of such treatment patterns.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 6, S1 (June 2024)
Code
RWD40
Topic
Epidemiology & Public Health, Real World Data & Information Systems, Study Approaches
Topic Subcategory
Health & Insurance Records Systems, Safety & Pharmacoepidemiology
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)