Evaluation of a Medicaid performance improvement project to reduce high-dose opioid prescriptions

Table 3 Results from interrupted time series regressions of opioid overdose outcomes before and during performance improvement project overall and by Coordinated Care Organizations (CCOs) high dose prescribing changes

	Any Opioid Overdose			Heroin-involved			Non-heroin involved
	Coefficient	95% CI	p-value	Coefficient	95% CI	p-value	Coefficient	95% CI	p-value
All CCOs
Intercept	15.37	13.71 to 17.03	< 0.01	8.69	7.93 to 9.45	< 0.01	7.26	5.42 to 9.10	< 0.01
Pre trend	−0.34	−0.60 to −0.08	0.01	−0.08	− 0.26 to 0.09	0.34	− 0.3	− 0.52 to − 0.07	0.01
Immediate change	0.60	−2.04 to 3.23	0.65	−1.18	−3.03 to 0.67	0.20	1.9	0.10 to 3.69	0.04
Trend change	0.57	0.26 to 0.87	< 0.01	0.24	0.01 to 0.47	0.04	0.40	0.16 to 0.64	< 0.01
10 CCOs with a significant decrease in proportion of opioid fills > =90 MME per day
Intercept	17.81	15.97 to 19.65	< 0.01	11.03	9.62 to 12.44	< 0.01	7.53	5.43 to 9.62	< 0.01
Pre trend	−0.40	−0.71 to −0.1	0.01	−0.11	− 0.37 to 0.16	0.43	− 0.37	− 0.62 to − 0.12	0.01
Immediate change	0.25	−2.83 to 3.32	0.87	−2.27	−4.93 to 0.38	0.09	2.74	0.81 to 4.67	0.01
Trend change	0.67	0.3 to 1.03	< 0.01	0.30	−0.04 to 0.63	0.08	0.48	0.2 to 0.75	< 0.01
6 CCOs without a significant decrease in proportion of opioid fills > =90 MME per day
Intercept	9.92	7.04 to 12.79	< 0.01	3.45	2.43 to 4.48	< 0.01	6.66	3.89 to 9.43	< 0.01
Pre trend	−0.17	−0.63 to 0.29	0.46	−0.01	−0.14 to 0.12	0.88	−0.15	− 0.59 to 0.29	0.49
Immediate change	1.31	−3.43 to 6.04	0.58	1.09	−0.58 to 2.76	0.19	0.13	−3.74 to 4.01	0.94
Trend change	0.33	−0.19 to 0.86	0.20	0.10	−0.1 to 0.3	0.31	0.24	−0.22 to 0.7	0.30

MME Morphine milligram equivalents, CCO coordinated care organization, CI confidence interval

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