142nd APHA Annual Meeting and Exposition

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Factors associated with prescription opiate use among pregnant women enrolled in Medicaid

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 1:10 PM - 1:30 PM

Ana Lopez Defede, Ph.D. , Department of Family and Preventive Medicine/SOM, Institute for Families in Society, Columbia, SC
Tammy Harris Cummings, PhD, MSPH , Division of Policy and Research on Medicaid and Medicare, University of South Carolina, Institute for Families in Society, Columbia, SC
Medha Vyavaharkar, MD, PhD , Institute for Families in Society, University of South Carolina, Arnold School of Public Health, Health Services Policy and Management, Columbia, SC
Background. While previous research details rising economic and health costs associated with non-medical use of prescription opiates among women, little is known about the scope of the problem among pregnant women, despite the potential maternal and fetal risks.  This study explores the prevalence of maternal opioid use among South Carolina Medicaid recipients and associated demographics among women who had a delivery in 2010 and were prescribed an opiate during 2009-2011.

Methods. Opioid National Drug Codes were pulled from the Opioid Medication Use Evaluation software.  A subset of women ages 18-34 who had an opioid drug claim and a baby was created from Medicaid claims data; age, race, eligibility, rural/urban, emergency room (ER) utilization, and mental health status were compared.  Descriptive statistics and chi-square tests were used to analyze the data. 

Results. Of 104,069 women who were prescribed opioids, 26.8% had a delivery (n=22,016).  Pregnant women were more likely ages 18-25 (64.38%), white/Caucasian (48.76%), part of a pregnancy/family eligibility group (91.43%), and from an urban area (67.76%).  21.56% had a mental health diagnosis, and 69.22% had visited the ER.  The relationship between these variables and opiate use was significant (p = <.0001).              

Conclusions. These data suggest the need for changes in service delivery that promote early identification of opioid-dependent pregnant women among client-risk groups, which is key to improving both maternal and infant outcomes, as well as reducing overall cost to state agencies resulting from high ER utilization, neonatal intensive care unit costs, prescription monitoring, medical complications, and treatment.  

Learning Areas:

Assessment of individual and community needs for health education
Clinical medicine applied in public health
Social and behavioral sciences

Learning Objectives:
Identify factors associated with prescription opiate use among pregnant women Describe a methodology for identifying potential opioid use during pregnancy using Medicaid claims data Discuss the benefits for state agencies of early identification of opioid-dependent pregnant women

Keyword(s): Drug Abuse, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have directed community-based organizations, served as a consultant with programs addressing the needs of at-risk vulnerable populations, worked as an advocate for enhanced health care and educational services for individuals with disabilities, and performed as a university unit administrator. I am presently a standing member of the AHRQ, Health Services and Systems Research Review Panel a federal appointment authorized by the US HHS Secretary.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.