Opioid and benzodiazepine dispensing and co-dispensing patterns among commercially insured pregnant women in the United States, 2007-2015
JournalBMC Pregnancy and Childbirth
MetadataShow full item record
AbstractBackground: Little is known about benzodiazepine and opioid-benzodiazepine co-dispensing patterns among pregnant women. Understanding these patterns is necessary to mitigate high-risk medication use during pregnancy. Our objective in this analysis was to evaluate opioid and benzodiazepine dispensing and co-dispensing patterns among commercially insured pregnant women in the United States. Methods: This retrospective study used a 10% random sample of commercially insured enrollees from the IQVIA™ Adjudicated Health Plan Claims Data from 2007 to 2015. The study included women (12-55 years of age) with completed pregnancies who had continuous medical and prescription drug coverage from 3 months prior to the date of conception through 3 months post-delivery. We estimated the prevalence of opioid and benzodiazepine dispensing and co-dispensing before, during, and after pregnancy, and evaluated trends in dispensing patterns across the study period (2007-2015) using Cochrane-Armitage tests. Chi-square tests were used to examine differences in demographic and clinical characteristics by dispensing and co-dispensing patterns. Among women that received an opioid or benzodiazepine during pregnancy, logistic regression models were used to quantify the association between sample characteristics and dispensing patterns (co-dispensing vs single dispensing). Results: Of 168,025 pregnant women that met our inclusion criteria, 10.1% received at least one opioid and 2.0% received at least one benzodiazepine during pregnancy, while 0.5% were co-dispensed these drugs. During the study period (2007 vs 2015), prevalence of opioid dispensing during pregnancy decreased from 11.2 to 8.6% (p < 0.01); while benzodiazepine dispensing increased from 1.3 to 2.9% (p < 0.01), and the prevalence of co-dispensing, while low and stable, increased slightly from 0.39 to 0.44% (p < 0.01). Older age, a higher comorbidity burden, pain diagnosis, anxiety diagnosis, and alcohol, tobacco, and drug use disorders, were all associated with an increased odds of co-dispensing during pregnancy. Conclusions: This study provides evidence that while opioid dispensing during pregnancy has decreased in the past decade, benzodiazepine dispensing has increased. The prevalence of opioid-benzodiazepine co-dispensing was rare and remained fairly stable during our study period. Those co-dispensed both drugs had a higher prevalence of adverse birth outcomes. Further research to establish the potentially causal relationship between opioid and benzodiazepine co-dispensing and adverse birth outcomes should be undertaken.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/15604
- Persistent opioid use following cesarean delivery: patterns and predictors among opioid-naïve women.
- Authors: Bateman BT, Franklin JM, Bykov K, Avorn J, Shrank WH, Brennan TA, Landon JE, Rathmell JP, Huybrechts KF, Fischer MA, Choudhry NK
- Issue date: 2016 Sep
- Dispensing of benzodiazepines and benzodiazepine-related drugs to pregnant women: a population-based cohort study.
- Authors: Riska BS, Skurtveit S, Furu K, Engeland A, Handal M
- Issue date: 2014 Nov
- Use of prescribed opioid analgesics and co-medication with benzodiazepines in women before, during, and after pregnancy: a population-based cohort study.
- Authors: Handal M, Engeland A, Rønning M, Skurtveit S, Furu K
- Issue date: 2011 Sep
- Prescription opioid dispensing in Australian children and adolescents: a national population-based study.
- Authors: Bell J, Paget SP, Nielsen TC, Buckley NA, Collins J, Pearson SA, Nassar N
- Issue date: 2019 Dec
- Controlled Substance Prescribing Patterns--Prescription Behavior Surveillance System, Eight States, 2013.
- Authors: Paulozzi LJ, Strickler GK, Kreiner PW, Koris CM, Centers for Disease Control and Prevention (CDC).
- Issue date: 2015 Oct 16