Obtaining ADHD prescriptions from multiple prescribers and/or filling prescriptions Geneticin across multiple pharmacies, often called doctor or pharmacy shopping, may reflect such unsanctioned use [1, 6]. Doctor-shopping behavior is increasingly recognized for opioids [7–10], but less is known about doctor-shopping behavior for ADHD medications. On the basis of data from California’s Prescription Monitoring Programs, 1.4 % of subjects dispensed ADHD medication see more had multiple providers in 2007 [11].
However, it is unclear how the behavior should be defined, how many individuals engage in the behavior (incidence), how often it occurs in a given subject or across subjects (frequency), the impact of age and sex on such behavior, or whether a small proportion of subjects are responsible for a large proportion of shopping episodes (concentration). Developing a definition of shopping behavior for ADHD medications will help identify subjects
who may be at higher risk of misusing/abusing or diverting. We sought to create an operational definition of shopping behavior that differentiated ADHD medications from medications with low risk of abuse or diversion, such as asthma medications. Such a definition will therefore decrease the risk of inappropriately identifying individuals with legitimate use of ADHD medications as being AG-881 at increased risk of misusing/abusing or diverting those medicines. Such misclassification may adversely affect the individual who is misclassified (e.g. social stigma) and, secondly, it is potentially deleterious to research studies that assess shopping behavior and abuse because random misclassification would bias the studies toward the null IKBKE and thus obscure the signals of interest. Once we defined shopping behavior, we also sought to describe its incidence and frequency, the impact of age and sex on shopping behavior, and the type of ADHD medication involved in the shopping episodes. 2 Method 2.1 Data Collection We conducted a population-based
retrospective cohort study using the LRx database, a longitudinal pharmacy database that covers 65 % of all retail dispensing in the US and includes all types of pharmacies—chains, food stores, mass merchandisers, and independent stores. From each of the pharmacies in the panel, the database captures all prescriptions that were dispensed, regardless of payment type. In particular, it includes prescriptions filled for patients with any insurance type (commercial, Medicare, Medicaid) and prescriptions paid for entirely in cash. Dispensing records are collected directly from pharmacies, which provide encrypted patient identifiers compliant with Health Insurance Portability and Accountability Act (HIPAA) privacy regulations. The LRx database includes data on the subject (de-identified), the pharmacy, and the prescriber.