Opioid Prescriptions in Women: Is the Data Accurate?

Background: In 2012, U.S. health care providers wrote more than 259 million opioid prescriptions, which is twice as many as in 1998. Approximately 1 in 10 women report the use of opioids for pain management during pregnancy. The Centers for Disease Control and Prevention (CDC) estimated that between 2008 and 2012, 39% of reproductive-aged women on Medicaid had filled a prescription for opioid medication each year, as did 28% of women with private insurance. The opioid epidemic extends to the state of New Jersey (NJ);however, limited data is available regarding opioid prescriptions among Medicaid and private insurance patients within the state. Objective: Evaluate opioid prescriptions filled in reproductive-aged women presenting in labor at a community teaching hospital in suburban New Jersey. Methods: We performed a retrospective cohort study using data obtained from patient records and the New Jersey Prescription Monitoring Program (NJPMP) database. We enrolled 200 patients that were admitted in labor between May 2015 and May 2016. Data was collected from reproductive-aged women during the one year preceding labor admission. We compared our findings to national data reported by the CDC using Chi-square analysis. Maternal demographic data were extracted from patient records and included age, insurance status (private insurance, Medicaid, and no insurance), race, and ethnicity. The primary outcome was opioid prescriptions filled. Results: Of the 200 women admitted in labor, 129 had private insurance, 63 had Medicaid, and 8 had no insurance. We found that 5.4% (7/129) of patients with private insurance, 4.8% (3/63) of patients with Medicaid, and 12.5% (1/8) of patients with no insurance filled opioid prescriptions. Overall, 5.5% (11/200) of women filled opioid prescriptions during the study period. Opioid prescriptions confirmed via NJPMP were significantly lower than rates reported by the CDC in Medicaid (4.8% vs. 41.4%, p-value 0.001) and private insurance (5.4% vs. 29.1%, p-value < 0.001) patients, respectively. Conclusion: Rates of opioid prescriptions filled were lower among our suburban cohort of women in New Jersey than national rates reported by the CDC. We did not confirm that patients with Medicaid filled more prescriptions than patients with private insurance. These discrepancies raise the question of whether a federal prescription monitoring program would better capture data than state-wide programs. Further research is needed to ensure that prescription monitoring programs are actually capturing accurate data.

Research on Component Law of Chinese Patent Medicine for Anti-influenza and Development of New Recipes for Anti-influenza by Unsupervised Data Mining Methods

Objective:To analyze the component law of Chinese patent medicines for anti-influenza and develop new prescriptions for anti-influenza by unsupervised data mining methods. Methods: Chinese patent medicine recipes for anti-influenza were collected and recorded in the database, and then the correlation coefficient between herbs, core combinations of herbs and new prescriptions were analyzed by using modified mutual information, complex system entropy cluster and unsupervised hierarchical clustering, respectively. Results: Based on analysis of 126 Chinese patent medicine recipes, the frequency of each herb occurrence in these recipes, 54 frequently-used herb pairs, 34 core combinations were determined, and 4 new recipes for influenza were developed. Conclusion: Unsupervised data mining methods are able to mine the component law quickly and develop new prescriptions.