Pharmacoepidemiology
Dispensations of prescription pain medications and opioids during the first year postpartum among TRICARE beneficiaries, 2013-2022 Celeste Romano* Celeste Romano Romano Romano Romano Romano UCLA
Objective: To describe person-time with any prescription pain medication and prescription opioids during the first year postpartum.
Methods: Birth and Infant Health Research program data were used to identify patients with a live birth while enrolled in TRICARE, the health insurance program for US military families, 2013–2022. Live births were identified using diagnostic and procedure codes in administrative medical records and confirmed via linkage to enrollment data. Patients were followed until 1-year postpartum, with loss to care and return to care accounted for in estimation of person-time. Dispensed pain medications, excluding those for opioid use disorder treatment, were identified in outpatient pharmacy records. The mean number of days on 1) any pain medication and 2) opioid medications were calculated overall and by military status. Mean differences comparing military vs non-military patients were estimated and bootstrap resampling was used to obtain estimates of precision.
Results: Overall, 1,037,793 live deliveries were identified, with 59% of postpartum patients filling a pain medication prescription and 41% filling an opioid prescription. Across 10.4 million person-months, 3% of person-time was spent on any prescription pain medication (mean ± SD: 10.3 ± 29.0 days) and 1% was spent on an opioid medication (mean ± SD: 3.7 ± 15.5 days). Approximately one-third of time spent on pain medications occurred within the first 2 weeks postpartum (34%). Compared to non-military patients, postpartum military service members, who comprised 17% of the sample, spent an additional 3.7 days, on average, on any pain medication (95% CI: 3.6-3.9), although time on opioid medications was comparable (mean difference: 0.4 days; 95% CI: 0.3-0.4).
Conclusions: Pain medications were frequently dispensed during the first year postpartum, particularly among military service members. Although opioid dispensations were also common, time on opioids was low, indicating good stewardship.