{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:43:50Z","timestamp":1790225030213,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T00:00:00Z","timestamp":1559692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Early detection of risky behaviors involving prescription opioids can assist prescribers in implementing safer prescribing. Patient\u2010to\u2010prescriber travel patterns may indicate potential opioid misuse. We introduce doctor hopping, patients bypassing nearby prescribers in favor of more distant ones, as a new spatial estimation of potentially risky behavior, and compare with traditional doctor shopping metrics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined all filled opioid prescriptions between 2015 and 2016 from the Arkansas Prescription Drug Monitoring Program. We calculated patient\u2010to\u2010prescriber travel times and number of prescribers bypassed for each prescription, adjusted for payment method. Opioid recipients traveling further than the nearest urban area and bypassing more prescribers than 99% of other recipients from the same zip code were identified as doctor hoppers. We calculated odds ratios to evaluate how doctor hopping and doctor shopping correspond to high\u2010risk opioid uses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Approximately 0.72% of all opioid recipients in Arkansas engaged in doctor hopping two or more times during the study period. Rates of doctor hopping varied spatially but were more common in rural areas. Doctor shopping was more common in urban areas. Both hopping and shopping were significantly associated with higher odds of engaging in high\u2010risk opioid use. The combination of doctor hopping and doctor shopping metrics can predict high\u2010risk use better than either metric alone and may allow for earlier detection than doctor shopping alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Doctor hopping is positively associated with high\u2010risk opioid use and is distinct from and complementary to doctor shopping. We recommend Prescription Drug Monitoring Program (PDMP) vendors incorporate similar spatial analyses into their systems.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4838","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T04:04:24Z","timestamp":1559793864000},"page":"1117-1124","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Doctor hopping and doctor shopping for prescription opioids associated with increased odds of high\u2010risk use"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0054-0627","authenticated-orcid":false,"given":"Sean G.","family":"Young","sequence":"first","affiliation":[{"name":"Department of Environmental and Occupational Health University of Arkansas for Medical Sciences College of Public Health  Little Rock AR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey J.","family":"Hayes","sequence":"additional","affiliation":[{"name":"Health Services Research and Development Center for Mental Healthcare and Outcomes Research Central Arkansas Veterans Healthcare System  Little Rock AR USA"},{"name":"Department of Psychiatry, Psychiatric Research Institute University of Arkansas for Medical Sciences College of Medicine  Little Rock AR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Aram","sequence":"additional","affiliation":[{"name":"Prescription Monitoring Program, Epidemiology Branch Arkansas Department of Health  Little Rock AR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Tait","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Arkansas for Medical Sciences College of Medicine  Little Rock AR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,5]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Centers for Disease Control and Prevention Opioid Overdose|Drug Overdose|CDC Injury CenterAvailable online:https:\/\/www.cdc.gov\/drugoverdose\/index.html(accessed on Jul 2 2018)."},{"key":"e_1_2_10_3_1","unstructured":"NHTSA's National Center for Statistics and Analysis2016 Fatal motor vehicle crashes: overview; 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