Abstract

The present study investigated variations in patient movement patterns between prescribers before and after House Bill 1 (HB1) implementation in Kentucky using network abstractions (PPN: prescriber-prescriber networks) from a one-month cross-sectional Schedule III prescription data in a Medicaid population. Network characteristics such as degree centrality distribution of PPN was positively skewed and revealed Dental Practitioners to be the highly connected specialty with opioid analgesic hydrocodone-acetaminophen to be the most commonly prescribed drug. Taxonomy enrichment of the prescriber specialties in PPN using chi-square test revealed a reduction in the enriched taxonomies Post-HB1 compared to Pre-HB1 with Dental practitioners being constitutively enriched (p < 0.05). PPNs were also found to exhibit rich community structure revealing inherent clustering of prescribers as a result of patient movement, and were markedly different from those generated by random graph models. The magnitude of deviation from random graphs decreased Post-HB1 relative to Pre-HB1. The proposed network approach provides system-level insights into prescribers with potential to complement classical reductionist approaches and aggregate statistical measures used in assessing changes in prescription patterns pre- and post- policy implementation. It can provide preliminary cues into drug seeking behavior, and facilitate targeted surveillance of prescriber communities.

Document Type

Article

Publication Date

3-30-2021

Notes/Citation Information

Published in Scientific Reports, v. 11, issue 1, 7142.

© The Author(s) 2021

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.

Digital Object Identifier (DOI)

https://doi.org/10.1038/s41598-021-86409-6

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