Opioid Prescribing During Pregnancy: Eight-Year Secular Trends at HealthPartners Medical Group
substance abuse, addiction, maternal and perinatal care, pharmaceuticals, costs
Background: Nationally, opioid prescribing for chronic noncancer pain has increased significantly over the last 20 years. Recently published evidence suggests that 20% to 40% of women received opioid prescriptions of varying doses and durations during pregnancy, which may cause increased risks of harm to mother and fetus. The purpose of this retrospective observational study was to determine the prevalence of opioid prescribing 3 months before pregnancy, each trimester of pregnancy and 3 months postpartum, as well as the secular utilization trend over an 8-year period, among member-patients at HealthPartners Medical Group (HPMG).
Methods: All pregnant member-patients of HPMG who delivered a live birth from 2006 to 2014 and had continuous pharmacy benefits beginning 3 months prior to their estimated pregnancy start through 3 months postpartum were included. Demographic, clinical, pharmaceutical and provider variables of interest were identified and described. Significant opioid prescribing during pregnancy was defined as more than 5 days’ supply prescribed in any 3-month period, excluding the 2-week postpartum period. Time trends for 2006–2014 were examined using linear regression.
Results: Of 11,565 pregnancies during the study period, significant opioid prescribing during 3 months before pregnancy, pregnancy or 3 months postpartum were observed in 862 (7.5%) pregnancies (816 unique women). A total of 454 (3.9%) pregnant women received significant opioid prescriptions during one or more trimesters of their pregnancy. From 2006 to 2014, the rate of significant opioid prescribing during each trimester of pregnancy and 3 months before and after pregnancy decreased -0.2% per year.
Conclusion: Significant opioid prescribing during the three trimesters of pregnancy as well as 3 months before and after pregnancy for member-patients of HPMG was significantly lower than reported studies from other populations and locations across the United States over the last 15 years. Furthermore, significant opioid prescribing was trending downward slightly over time, rather than rising as reported elsewhere. Explanatory factors for these findings should be explored.
Elliott TE, Frail CK, Pawloski PA, Thomas AJ, Werner AM, Rossom RC. Opioid prescribing during pregnancy: eight-year secular trends at HealthPartners Medical Group. J Patient Cent Res Rev. 2017;4:190.