Development of Metrics to Assess Appropriate Prescribing of Opioids in the Mini-Sentinel Distributed Database (MSDD)

Project Title Development of Metrics to Assess Appropriate Prescribing of Opioids in the Mini-Sentinel Distributed Database (MSDD)
Date Posted
Monday, November 20, 2017
Status
Complete
Deliverables
Description

Opioids Drug Screen Metrics

The Workgroup created a metric to examine opioid prescribing patterns in the Mini-Sentinel Distributed Database (MSDD): a drug screens metric that characterized the proportion of new users of extended-release and long-acting (ER/LA) opioids who receive a drug screen assay before and/or after the opioid dispensing. The drug screen metric utilized an existing tool developed by the MSOC.

The Opioid Analgesics Prescribing Trends Workgroup has requested execution of the Cohort Identification and Descriptive Analysis (CIDA) tool, version 2.0.7, to find estimates of the percentage of extended-release and long-acting (ER/LA) opioid analgesics users who have a drug screen in the month prior to opioid use or in the six months after opioid use. The query was run against the MSDD for the time period of January 1, 2009 to December 31, 2013. The request was distributed to 15 Data Partners on July 29, 2015. Report 1 contains results for ER/LA opioid analgesics and Report 2 contains results for ER oxycodone.

This request was designed to identify exposures with and without drug screens in the month prior or within six months after opioid initiation. The number of exposure episodes in the MSDD was calculated overall and was stratified by age group, sex, and year.

Extended-Release and Long-Acting (ER/LA) Opioid Use

The Workgroup created a metric to examine opioid prescribing patterns in the Mini-Sentinel Distributed Database (MSDD): an opioid tolerance metric that characterized the proportion of patients who get an ER/LA opioid analgesic dispensed after meeting criteria for becoming opioid tolerant.  The opioid tolerance metric utilized de novo programming.

FDA has requested execution of the Cohort Identification and Descriptive Analysis (CIDA) tool, version 2.0.8, to investigate the estimated numbers of ER (extended-release) and LA (long-acting) opioid analgesics users.

This request was designed to calculate background rates.  The number of qualifying users with the exposure, number of eligible members, and member days were calculated overall and were stratified by age group, sex, and year.

Medical Product
Butrans
buprenorphine
extended-release (ER) oxycodone
extended-release and long-acting (ER/LA) opioid analgesic
fentanyl
fentanyl transdermal system
hydrocodone bitartrate
hydromorphone HCL
methadone HCL
morphine sulfate
morphine sulfate/naltrexone
oxycodone HCL
oxymorphone HCL
tapentadol HCL
Population / Cohort
All individuals 0-64 years of age
Time Period
January 1, 2009 – December 31, 2013
Data Sources
Mini-Sentinel Distributed Database (MSDD)
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