EHR Data Reveal Patients in Rural Areas Are Prescribed More Opioids

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Using electronic health record (EHR) prescription data, a study revealed that patients living in rural areas have an 87 percent higher chance of receiving an opioid prescription.

The study, which appeared in the U.S. Centers for Disease Control’s (CDC’s) Prevention Morbidity and Mortality Weekly Report, used athenahealth’s deidentified EHR prescription data from more than 31,000 primary healthcare providers serving approximately 17 million patients. Patient data were collected each week from January 2014 to March 2017.

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Each week that a patient had at least one athenahealth record, that patient contributed one patient-week to the study. It was also noted whether primary care providers using athenahealth’s EHR system prescribed one or more opioids.

Overall, more than 128 million patient-weeks of data were included in the analysis, of which, at least one opioid was prescribed during approximately 8.8 million (6.9 percent) of the patient-weeks.

Researchers analyzed data to evaluate trends and assess how prescribing practices varied among six urban-rural classification categories of counties.

The percentage of patients with opioid prescriptions ranged from 5.2 percent in large metropolitan areas to 9.6 percent in the most rural counties.

Patients in the most rural counties had a higher chance of receiving an opioid prescription compared with people in large metropolitan areas. But across all groups, the odds of receiving an opioid prescription decreased significantly after March 2016, when CDC’s Guideline for Prescribing Opioids for Chronic Pain was released.

From 2014 to 2015, 7.4 percent of patients received an opioid prescription. After the guidelines were put in place, that rate had fallen to 6.4 percent.

“Data from EHRs can effectively supplement traditional surveillance methods for monitoring trends in opioid prescribing and other areas of public health importance, with minimal lag time under ideal conditions,” the researchers wrote.

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