Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Opioids and the Dermatology Medicare Population

JAMA Dermatology; ePub 2018 Feb 7; Cao, et al

Opioid prescribing among dermatologists is limited and concentrated in the surgical setting, but it may be associated with a substantial number of adverse events that serve as a reminder to emphasize non-opioid pain medications in the postoperative setting. This according to a recent cross-sectional study that evaluated opioid prescriptions by dermatologists to Medicare beneficiaries from January 1 to December 31, 2014. A systematic literature review was conducted to estimate the outcome of opioid prescribing practices on the exposed population. Investigators found:

  • Of the 12,537 dermatologists in the study, 5,305 (42.3%) prescribed no opioid claims, 5,408 (43.1%) prescribed 1 to 10 opioid claims, and 1,824 (14.5%) prescribed >10 opioid claims.
  • A total of 108 dermatologists (93.9%) in the top 1% of opioid prescribers (n=115) work in a surgical practice.
  • Estimates suggest that opioids prescribed by dermatologists could annually lead to 3,877 to 7,602 beneficiaries continuing to use opioids at 1 year and 1,825 to 4,209 continuing to use opioids at 3 years.

Cao S, Karmouta R, Li DG, Din RS, Mostaghimi A. Opioid prescribing patterns and complications in the dermatology Medicare population. [Published online ahead of print February 7, 2018]. JAMA Dermatology. doi:10.1001/jamadermatol.2017.5835.

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Trends in Medicare Billing Among Mohs Surgeons, Dermatolog Surg; ePub 2018 Sep 7; Tsai, et al