Academic Journal
Changes in opioid prescribing and high-risk co-prescribing after implementation of the 2016 CDC opioid guideline among older adults with and without cancer.
| Τίτλος: | Changes in opioid prescribing and high-risk co-prescribing after implementation of the 2016 CDC opioid guideline among older adults with and without cancer. |
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| Συγγραφείς: | Olateju OA; The Prescription Drug Misuse Education and Research (PREMIER) Center, College of Pharmacy, University of Houston, Houston, TX, USA.; Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, 4349 Martin Luther King Boulevard, Houston, TX, USA., Byun JY; Division of Outcomes Research and Quality, Department of Surgery, Penn State College of Medicine, Hershey, PA, USA.; School of Pharmacy, Sungkyunkwan University, Suwon, South Korea., Okeke CM; The Prescription Drug Misuse Education and Research (PREMIER) Center, College of Pharmacy, University of Houston, Houston, TX, USA.; Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, 4349 Martin Luther King Boulevard, Houston, TX, USA., Shen C; Division of Outcomes Research and Quality, Department of Surgery, Penn State College of Medicine, Hershey, PA, USA.; Division of Health Services & Behavioral Research, Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA., Thornton JD; The Prescription Drug Misuse Education and Research (PREMIER) Center, College of Pharmacy, University of Houston, Houston, TX, USA. jdthornt@Central.UH.EDU.; Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, 4349 Martin Luther King Boulevard, Houston, TX, USA. jdthornt@Central.UH.EDU. |
| Πηγή: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2026 Oct 09; Vol. 34 (11). Date of Electronic Publication: 2026 Oct 09. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Springer International Country of Publication: Germany NLM ID: 9302957 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-7339 (Electronic) Linking ISSN: 09414355 NLM ISO Abbreviation: Support Care Cancer Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Berlin : Springer International, c1993- |
| Ιατρικοί όροι (MeSH): | Analgesics, Opioid*/administration & dosage , Analgesics, Opioid*/therapeutic use , Practice Patterns, Physicians'*/statistics & numerical data , Practice Patterns, Physicians'*/standards , Neoplasms*/complications , Practice Guidelines as Topic*, Medicare/statistics & numerical data ; Hypnotics and Sedatives/administration & dosage ; Benzodiazepines/administration & dosage ; Antidepressive Agents/administration & dosage ; Drug Prescriptions/statistics & numerical data ; Humans ; Aged ; Female ; United States ; Male ; Aged, 80 and over ; SEER Program ; Centers for Disease Control and Prevention, U.S. |
| Περίληψη: | Purpose: To evaluate changes in opioid prescribing and high-risk opioid co-prescribing before and after the 2016 CDC Guideline among Medicare beneficiaries with and without cancer. Methods: Using SEER-Medicare data (2014-2017), we identified beneficiaries diagnosed with breast, colon, or lung cancer and a comparison cohort without cancer. All patients were continuously enrolled in Medicare Parts A, B, and D and not enrolled in Medicare Advantage. The pre-policy period was January 2014-November 2015 and the post-policy period was April 2016-September 2017. Outcomes assessed within 3 months of diagnosis or index claim included monthly opioid prescribing rates, monthly days of opioid supply, daily morphine milligram equivalents (MME), and high-risk co-prescribing with benzodiazepines, antidepressants, or non-benzodiazepine sedatives. Difference-in-difference models compared changes between groups before and after guideline implementation, adjusting for baseline characteristics. Results: The study included 42,931 cancer and 108,218 patients without cancer. After guideline implementation, opioid prescribing declined in both groups but more substantially among patients without cancer, while changes among patients with cancer were minimal. Difference-in-difference estimates indicated smaller reductions among cancer versus patients without cancer in monthly opioid prescribing (- 0.14; 95% CI, - 0.17 to - 0.11; p < 0.0001) and days of supply (- 3.07; 95% CI, - 3.68 to - 2.45; p < 0.0001). Changes in daily MME did not differ significantly (16.73; 95% CI, - 43.36 to 76.82; p = 0.5853). High-risk co-prescribing declined overall but decreased less among patients with cancer for opioid-benzodiazepine, opioid-antidepressant, and opioid-non-benzodiazepine sedative combinations (all p < 0.0001). Conclusion: Following the 2016 CDC guideline, reductions in opioid prescribing and high-risk co-prescribing were greater among patients without cancer, with minimal change observed among patients with cancer. (© 2026. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
| Competing Interests: | Declarations. Ethics approval: Datasets are de-identified and fully compliant with the Health Insurance Portability and Accountability Act (HIPAA); therefore the Penn State Cancer Institute Institutional Review Board deemed the study exempt from human subjects’ review. Human ethics and consent to participate: Not applicable. Clinical trial number: Not applicable. Prior presentations: None. Competing interests: The authors declare no competing interests. |
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| Grant Information: | 1H79TI083288 Texas Health and Human Services Commission |
| Contributed Indexing: | Keywords: CDC opioid guideline; Cancer; Opioid co-prescribing; Opioid prescribing; SEER–Medicare |
| Substance Nomenclature: | 0 (Analgesics, Opioid) 0 (Hypnotics and Sedatives) 12794-10-4 (Benzodiazepines) 0 (Antidepressive Agents) |
| Entry Date(s): | Date Created: 20261008 Date Completed: 20261009 Latest Revision: 20261010 |
| Update Code: | 20261011 |
| DOI: | 10.1007/s00520-026-11273-x |
| PMID: | 42850338 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1433-7339 |
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| DOI: | 10.1007/s00520-026-11273-x |