Original Contributions| Volume 48, ISSUE 4, P424-431.e1, April 2015

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Characteristics of Emergency Department “Doctor Shoppers”



      There is a need to accurately identify patients at risk for drug abuse before giving a prescription for a scheduled medication.


      Our aim was to describe a subset of emergency department (ED) patients that had eight or more schedule II−V prescriptions filled from eight or more providers in 1 year, known as “doctor-shopping” (DS) behavior, to compare demographic features of DS and non-DS patients, and to determine clinical factors associated with DS.


      We conducted a prospective, observational study of emergency providers' (EPs) assessment of patients with back pain, dental pain, or headache. EPs recorded patient demographics, clinical characteristics, and numbers of schedule II−V prescriptions, subset opioid prescriptions, providers, and pharmacies utilized in a 12-month period, as reported on the state prescription drug-monitoring program. χ2 and t-tests were used to compare DS with non-DS patients on demographics; a multivariate logistic regression was performed to determine clinical factors associated with DS.


      Five hundred and forty-four patient visits were recorded; 12.3% (n = 67) had DS behavior. DS and non-DS patients were similar in sex but differed in age, race, chief complaint, and weekday vs. weekend arrival. DS patients utilized a median of 12.0 (interquartile range [IQR] 9.0–18.0) providers compared with a median of 1.0 (IQR 0–2.0) providers in the non-DS group. Reporting allergies to non-narcotic medications (odds ratio [OR] = 3.1; 95% confidence interval [CI] 1.4–6.9; p = 0.01), requesting medications by name (OR = 2.7; 95% CI 1.5–4.9; p < 0.01), and hospital site (OR = 2.0; 95% CI 1.1–3.6; p = 0.03) were significantly associated with DS.


      There are multiple clinical characteristics associated with DS in this patient population.


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