Opioid prescription fill rates after emergency department discharge.
OBJECTIVE
Opioid prescription fill rates and the time to fill after emergency department (ED) discharge were studied.


METHODS
Data were evaluated for all patients discharged from the ED between September 1, 2011, who were February 1, 2012, who were diagnosed with one of the following: dental pain, jaw pain, flank pain, abdominal pain, pelvic pain, back pain, neck pain, knee pain, headache, fracture, or sprain. Clinical information was abstracted via computer algorithm, and prescription filling within 100 days of prescription writing was determined by cross-referencing patient demographics with the state prescription drug monitoring program. Logistic regression analysis and a Cox proportional hazards model were used to determine if any clinical and demographic characteristics were associated with fill rates or the time to fill, respectively.


RESULTS
Of the 2243 patients who received an opioid prescription at ED discharge, 1775 (79%) filled it, with a median time to fill of 0 days. On adjusted analysis, characteristics associated with filling the opioid prescriptions included Caucasian race, being insured by the federal government or through a state indigent assistance program, a chief complaint of back pain, and a history of filling an opioid prescription within the past year. No characteristics were predictive of a prolonged time to filling.


CONCLUSIONS
One in five patients who received an opioid prescription at discharge from an urban academic ED did not fill it. Several factors may be associated with a greater likelihood of filling, such as insurance status and history of filling an opioid prescription within the past year.
Department of Emergency Medicine, Center for Education in Health Sciences, Northwestern University, Chicago, IL. howard.kim@northwestern.edu.
Howard S
HS
Kim
Section of Medical Pharmacology and Toxicology, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CORocky Mountain Poison and Drug Center, Denver, CO.
Kennon J
KJ
Heard
Rocky Mountain Poison and Drug Center, Denver, CO.
Susan
S
Heard
Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, CORocky Mountain Poison and Drug Center, Denver, CO.
Jason A
JA
Hoppe
D000046:Academic Medical Centers / Q000639:trends; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D015331:Cohort Studies; D011307:Drug Prescriptions; D004636:Emergency Service, Hospital / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D010351:Patient Discharge / Q000639:trends*; D055553:Prescription Drugs / Q000627:therapeutic use*
D000701:Analgesics, Opioid; D055553:Prescription Drugs