Skip to main content

Advertisement

Table 1 Patient characteristics and utilization patterns by medication and group, baseline treatment year

From: Use of power-law analysis to predict abuse or diversion of prescribed medications: proof-of-concept mathematical exploration

  PLG1 PLG2 PLG3 PLG4 Lorenz-25 Lorenz-1
Alprazolam (n) 283,970 187,266 57,854 11,662 137,047 5384
 % of sample 52.5 34.6 10.7 2.2 25.3 1.0
 Threshold dosage/daya N/A 0.33 1.69 5.04 0.90 7.40
 Ratio threshold:maximum N/A 0.08 0.42 1.26 0.23 1.85
 Female (%) 73.0 66.9 63.6 63.2 64.1 63.9
 Mean age 46 48 48 48 48 49
 Mean claims > max dose/monthb 0.13 0.22 0.33 0.84 0.33 0.91
 Lorenz-1 (%) 0.0 0.0 0.0 46.2 3.9 100.0
 Diagnoses and utilizationc %       
  Anxiety 45.4 49.6 55.9 58.9 53.9 59.3
  Cancer 6.1 6.3 5.7 5.7 5.9 5.8
  Insomnia 12.2 14.5 14.4 15.5 14.6 15.3
  Pain 55.8 61.4 66.8 68.2 65.2 67.8
  SUD 8.1 12.9 18.5 20.6 16.9 19.6
 IPH (% with ≥ 1) 7.1 9.5 11.8 11.6 11.0 10.1
  Pain 2.2 3.3 4.5 4.6 4.1 4.1
  SUD 1.3 2.4 3.6 4.0 3.2 3.3
  Z drug hypnoticd 11.3 16.1 18.1 18.6 17.7 18.0
  Gabapentinc 3.7 6.6 8.9 8.9 8.2 8.5
  Opioidc 24.2 37.6 51.9 52.1 47.5 50.4
Gabapentin (n) 208,848 106,213 2476 N/A 81,534 3266
 % of sample 65.8 33.4 0.8   25.7 1.0
 Threshold dosage/daya N/A 766.03 12,509.59   1034.25 10,356.16
 Ratio threshold:maximum N/A 0.21 3.47   0.29 2.88
 Female (%) 64.6 61.7 59.1   61.2 60.1
 Mean age 50 51 52   51 52
 Mean claims > max dose/monthb 0.00 0.06 0.80   0.10 0.77
 Lorenz-1 (%) 0 0.7 100.0   4.0 100.0
 Diagnoses and utilizationc %
  Anxiety 20.6 22.7 27.9   23.0 27.3
  Cancer 8.1 8.5 8.6   8.5 8.4
  Insomnia 12.2 13.8 17.6   14.0 17.2
  Pain 84.4 86.4 90.0   86.7 89.7
  SUD 12.9 15.8 21.2   16.4 20.5
 IPH (% with ≥ 1) 14.1 16.2 17.1   16.4 16.7
  Pain 7.9 9.6 10.9   9.8 10.6
  SUD 2.9 3.4 5.0   3.5 4.7
 Benzodiazepined 21.3 26.6 27.8   26.9 27.2
 Z drug hypnoticd 9.7 12.9 12.9   13.0 12.7
 Opioidc 41.9 51.6 57.9   52.9 56.1
Opioids (n) 2,172,054 217,918 67,514 N/A 615,003 24,884
 % of sample 88.4 8.9 2.7   25.0 1.0
 Threshold dosage/daya N/A 22.60 130.19   5.82 271.15
 Ratio threshold:maximum N/A 0.45 2.60   0.12 5.42
 Female (%) 59.4 52.2 45.7   53.6 46.2
 Mean age 45 48 47   48 49
 Mean claims > max dose/monthb 0.08 0.52 1.44   0.44 1.63
 Lorenz-1 (%) 0 0 36.9   4.0 100.0
 Diagnoses and utilizationc %
  Anxiety 14.5 24.5 25.7   22.3 26.2
  Cancer 6.6 7.1 6.3   7.4 6.6
  Insomnia 7.8 12.5 12.7   11.9 13.6
  Pain 66.8 87.8 83.1   85.1 88.3
  SUD 9.5 24.8 36.4   20.8 32.2
 IPH (% with ≥ 1) 12.5 17.9 15.5   18.7 15.6
  Pain 4.9 10.4 9.2   11.3 9.8
  SUD 1.5 4.5 5.1   3.8 5.0
 Benzodiazepined 14.2 35.4 38.2   30.8 41.2
 Z drug hypnoticd 6.4 14.8 14.4   13.2 15.2
 Gabapentinc 4.9 16.9 16.5   14.1 17.0
  1. IPH inpatient hospital stay, Lorenz-1 top 1% of utilizers, Lorenz-25 top quartile (25%) of utilizers, mg milligrams, MME morphine-milligram equivalents, PLG power-law group, SUD substance use disorder
  2. aMedication supply was measured as milligrams for alprazolam (n = 540,752) and gabapentin (n = 317,537), and MMEs for opioids (n = 2,457,486). All medication claims were measured in the baseline treatment year (i.e., 12-month period beginning with the first observed medication claim of the type shown in the row label); sample is not limited to new utilizers. Threshold is the dosage that defines the category lower limit; for example, > 0.33 and ≤ 1.69 mg defined PLZ-2 alprazolam
  3. bTotal supply dispensed in each claim divided by days supply; rate was measured as total number of claims exceeding labeled/recommended dosage (4 mg/day alprazolam, 3600 mg/day gabapentin; 50 MME/day opioids), divided by 12
  4. cMeasured in the baseline treatment year. Diagnosis codes are shown in Additional file 1: Appendix S4
  5. dBenzodiazepines measured: clonazepam, diazepam, lorazepam and, for users of gabapentin and opioids, alprazolam. Z-drugs measured: eszopiclone and zolpidem. Percentages of patients with ≥ 2 claims