(1079) Trends in Outpatient Opioid Prescriptions during Pregnancy by Clinician Specialty in Utah, 2014-2017

Statewide public health efforts have sought to reduce opioid prescriptions in Utah, which has one of the highest rates of opioid prescribing during pregnancy in the country. The objective of this study was to evaluate trends in outpatient opioid prescriptions during pregnancy in Utah from 2014 to 2017 and to determine prescribing trends by clinician specialty.


Study Design:

We used the Utah All Payer Claims Database to assess opioid prescription trends between 2014-2017. We included all individuals with pregnancies >20 weeks’ gestation. For each study year, we calculated the number of outpatient opioid prescriptions dispensed per 1000 pregnancies. We included outpatient opioid prescriptions dispensed during any trimester of pregnancy prior to delivery but not in the postpartum period. Over the study period, we tested linear trends for opioid prescriptions overall and by clinician specialty using generalized linear models.


Results:

From 2014 to 2017, 51,360 opioid prescriptions were dispensed across 192,451 unique pregnancies. Outpatient opioid prescriptions during pregnancy decreased from 313.7 per 1000 pregnancies in 2014 to 182.7 per 1000 pregnancies in 2017 (p < .001) (Figure and Table). The number of opioid prescriptions per 1000 pregnancies declined for all specialties (Table). Obstetrician-gynecologists were the most common prescribers (31.2%), followed by family medicine physicians (20.8%), emergency medicine physicians (EM) (11.9%), dentists (9.7%), physician assistants (PA) (6.0%) and advanced practice registered nurses (APRN) (5.4%). Significant declining linear trends in outpatient opioid prescriptions were observed for all specialties (P < .001 for all) except PA (P=.18) and APRN (P=.89).


Conclusion:

The number of prescriptions for opioids dispensed during pregnancy in Utah decreased by 41.8% from 2014 to 2017. Decreasing trends were observed for most specialties. These results suggest that statewide public health efforts in conjunction with national efforts to decrease opioid prescribing in pregnancy may have been effective.