Crego Submits R03 Application

Kudos to Nancy Crego and her entire team for the submission of her Agency for Healthcare Research and Quality (AHRQ) R03 application entitled “Differences in Opioid Prescribing Patterns for Children and Adolescents 2014-2018." This proposal requests funding for an18-month period with a start date of July 1, 2019.

This proposal addresses the Agency for Healthcare Research and Quality (AHRQ) special emphasis notice NOT-HS-18-015 using health services research methods to advance understanding of the opioid crisis. The opioid epidemic in the United States (US) has contributed to high numbers of deaths; 63,600 in 2016. Over prescription of opioids has played a major role in this epidemic. In 2012 an average of 97 opioid prescriptions were written/100 people in North Carolina (NC), placing it in the highest quartile for this measure in the US. Although state-level drug monitoring programs and restrictions in opioid prescribing may lead to overall decreases in prescribing rates, the effect of these policies on children and adolescents, particularly those with chronic conditions has not been examined. The gap in knowledge about opioid prescribing in children and adolescents is a barrier to developing interventions and policies that consider the needs of children with acute and chronic pain. We will study 0-17 year-olds with at least 1 opioid prescription in 1 year, enrolled in NC Medicaid for at least 11 months in 2014 or 2018. The study aims are to: 1) Describe opioid prescriptions (prevalence, drug name, mean opioid prescription claims and mean days filled /enrollee/year), enrollee characteristics (age, race, ethnicity, gender, area of residence), diagnosis (chronic/not chronic) and prescribers 2) compare differences in number of opioid prescription claims and number of days filled/enrollee/year, enrollee characteristics, diagnosis and prescribers between 2014 and 2018. We will also explore the association of chronic diagnosis on number of opioid prescription claims and number of days filled/enrollee/year, considering the influence of enrollee characteristics, prescriber and claim year. Results of this study will inform policymakers of the affects of state-level opioid reducing policies on 0-17 year-olds and development of opioid use reduction interventions targeting high prescribing regions, patients and specialty providers in NC.