Predicting Opioid Overdose Deaths Using Prescription Drug Monitoring Program Data.

Predicting Opioid Overdose Deaths Using Prescription Drug Monitoring Program Data.

Publication date: Dec 01, 2019

Prescription Drug Monitoring Program data can provide insights into a patient’s likelihood of an opioid overdose, yet clinicians and public health officials lack indicators to identify individuals at highest risk accurately. A predictive model was developed and validated using Prescription Drug Monitoring Program prescription histories to identify those at risk for fatal overdose because of any opioid or illicit opioids.

From December 2018 to July 2019, a retrospective cohort analysis was performed on Maryland residents aged 18-80 years with a filled opioid prescription (n=565,175) from January to June 2016. Fatal opioid overdoses were identified from the Office of the Chief Medical Examiner and were linked at the person-level with Prescription Drug Monitoring Program data. Split-half technique was used to develop and validate a multivariate logistic regression with a 6-month lookback period and assessed model calibration and discrimination.

Predictors of any opioid-related fatal overdose included male sex, age 65-80 years, Medicaid, Medicare, 1 or more long-acting opioid fills, 1 or more buprenorphine fills, 2 to 3 and 4 or more short-acting schedule II opioid fills, opioid days’ supply ?91 days, average morphine milligram equivalent daily dose, 2 or more benzodiazepine fills, and 1 or more muscle relaxant fills. Model discrimination for the validation cohort was good (area under the curve: any, 0.81; illicit, 0.77).

A model for predicting fatal opioid overdoses was developed using Prescription Drug Monitoring Program data. Given the recent national epidemic of deaths involving heroin and fentanyl, it is noteworthy that the model performed equally well in identifying those at risk for overdose deaths from both illicit and prescription opioids.

Ferris, L.M., Saloner, B., Krawczyk, N., Schneider, K.E., Jarman, M.P., Jackson, K., Lyons, B.C., Eisenberg, M.D., Richards, T.M., Lemke, K.W., and Weiner, J.P. Predicting Opioid Overdose Deaths Using Prescription Drug Monitoring Program Data. 04279. 2019 Am J Prev Med (57):6.

Concepts Keywords
Benzodiazepine Epidemic deaths
Buprenorphine Opioids
Calibration Drugs
Cohort Psychoactive drugs
Discrimination RTT
Epidemic Euphoriants
Fentanyl Morphinans
Heroin Ethers
Logistic Regression Phenols
Maryland Drug overdose
Medicaid Fentanyl
Medicare Heroin
Milligram Buprenorphine
Morphine
Multivariate
Muscle Relaxant
Opioid
Opioid Overdose
Opioids
Overdose
Overdose Deaths
Split

Semantics

Type Source Name
drug DRUGBANK Buprenorphine
drug DRUGBANK Morphine
drug DRUGBANK Benzodiazepine
drug DRUGBANK Diamorphine
drug DRUGBANK Fentanyl

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