Disproportionate High-Risk Nonsteroidal Anti-inflammatory Drug (NSAID) Prescribing in Rural Virginia
Rockwell, M. S.; Grubb, C.; Turner, J.; Vinson, M.; Yim, I.; Hanlon, A.; Epling, J.
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IntroductionIndividuals living in rural areas experience limited access to safe and effective pain management. Using insurance claims for 1.3 million Virginians, we evaluated variation in high-risk nonsteroidal anti-inflammatory drug (NSAID) prescribing by rurality during 2019-2021. MethodsWe applied a difference-in-differences model to analyze the effect of the COVID-19 pandemic on high-risk NSAID prescribing rates, stratifying incidence rate ratios (IRR) by rurality. ResultsAlthough high-risk NSAID prescribing rates decreased modesty during 2020-2021, rural areas experienced significantly higher prescribing rates throughout the study period (IRR: 1.594 [95% CI: 1.408, 1.803], p<.001). ConclusionsContext-driven efforts to de-implement high-risk NSAID prescribing in rural Virginia are needed.
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