CWCI Studies Polypharmacy Claims


Sacramento, CA - The use of pharmaceuticals is an important component of healthcare, including in the treatment of injured workers, but interactions between drugs are always a concern and should figure prominently in medication management. 

This is especially true given that recent research has shown that concurrent use of multiple medications (polypharmacy) to treat one or multiple medical conditions has become prevalent, with up to 10 percent of the U.S. population and up to 30 percent of older adults taking five or more drugs simultaneously. 

The risks are particularly high when opioids or other controlled substances are part of the drug mix, underscoring the importance of utilization review and other forms of clinical oversight.  Because of these risks, polypharmacy has generated concern across healthcare systems, including worker’s compensation. 

This CWCI study uses 2016 - 2017 prescription data to measure the prevalence of polypharmacy in California workers' compensation and to identify the types of drugs included in polypharmacy prescribing. For the purposes of this study, claims with five or more concurrent medications during the two-year study period were defined as polypharmacy claims. Among the key findings: 

- Twenty-four percent of claims with at least one dispensed drug during calendar years 2016 and 2017 had three or more different prescription drugs concurrently dispensed. 
- The likelihood that indemnity was paid on a claim increased with the number of concurrent prescriptions. About half (51. 6 percent) of the claims with one to two prescription drugs were indemnity cases versus 91.3 percent of those with five or more concurrent drugs. 
- Polypharmacy claims tend to be older, with 21.5 percent of polypharmacy claims being at least 10 years old, compared to 6.0 percent of the non-polypharmacy claims. 
- Claims involving back conditions without spinal cord involvement (including sprain and strain injuries) account for the highest proportion of polypharmacy claims (21.3 percent). 
- A high proportion of the polypharmacy claims involve older workers, with more than half (52.3 percent) of the polypharmacy claims involving injured workers who were 50 years of age or older versus 38.3 percent of the claims with fewer concurrent medications. 
- Analgesic opioids and anti-inflammatories were the top two therapeutic drug groups when three or more drugs were concurrently prescribed. 
- The combination of opioids, anti-inflainmatories and muscle relaxants accounted for the highest proportion of three-drug combinations (4.5 percent).

CWCI has issued its polypharmacy study in a Research Note, "An Examination of Polypharmacy Claims in California Workers’ Compensation," which has additional data, graphics and analyses. Read More...


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