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Prevalence of Opioid and Benzodiazepine Prescriptions for Osteoarthritis.
Arthritis Care Res (Hoboken). 2020 08; 72(8):1081-1086.AC

Abstract

OBJECTIVE

Opioids and benzodiazepines are commonly used for management of osteoarthritis, despite evidence-based recommendations to the contrary. This study aimed to quantify the prevalence of opioid and benzodiazepine prescribing for osteoarthritis. Additionally, we aimed to characterize risk factors for prescription drug misuse, abuse, and diversion among this population.

METHODS

We conducted a descriptive analysis of adult outpatient encounters with a primary diagnosis of osteoarthritis during a 1-year period at a large health care system, excluding cancer and outpatient procedures. Demographic data, prescription data, and patient-specific risk factors were collected. Descriptive analysis was conducted to characterize arthritis patients who received and did not receive prescription opioids.

RESULTS

During 1 year, our system had 31,123 outpatient encounters for osteoarthritis. Opioids and benzodiazepines were prescribed for nearly 27% of the encounters (n = 8,420). In all, 43% of the encounters involved patients age ≥65 years. Hydrocodone-acetaminophen was the most common medication prescribed (34.3%). Most prescriptions were written by pain specialists (53%). A total of 35.5% of patients had a risk factor for prescription misuse, the most prevalent being early refill and a history of receiving ≥3 prescriptions in the past month.

CONCLUSION

Prescriptions for opioids and benzodiazepines continue to be written for osteoarthritis. These prescriptions may pose a risk for adverse outcomes since >1 in 5 patients receiving prescriptions had a risk factor for misuse. Continued efforts to improve compliance with evidence-based guidelines as well as multimodal and alternative pain management pathways are critical to help curb the use of opioids for management of osteoarthritis-related pain.

LEVEL OF EVIDENCE

level IV.

Authors+Show Affiliations

Carolinas Medical Center and OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.Carolinas Medical Center and OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.Carolinas Medical Center and OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.OrthoCarolina Hip and Knee Center and Atrium Health Musculoskeletal Institute, Atrium Health, Charlotte, North Carolina.Carolinas Medical Center and OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

31127868

Citation

Alamanda, Vignesh K., et al. "Prevalence of Opioid and Benzodiazepine Prescriptions for Osteoarthritis." Arthritis Care & Research, vol. 72, no. 8, 2020, pp. 1081-1086.
Alamanda VK, Wally MK, Seymour RB, et al. Prevalence of Opioid and Benzodiazepine Prescriptions for Osteoarthritis. Arthritis Care Res (Hoboken). 2020;72(8):1081-1086.
Alamanda, V. K., Wally, M. K., Seymour, R. B., Springer, B. D., & Hsu, J. R. (2020). Prevalence of Opioid and Benzodiazepine Prescriptions for Osteoarthritis. Arthritis Care & Research, 72(8), 1081-1086. https://doi.org/10.1002/acr.23933
Alamanda VK, et al. Prevalence of Opioid and Benzodiazepine Prescriptions for Osteoarthritis. Arthritis Care Res (Hoboken). 2020;72(8):1081-1086. PubMed PMID: 31127868.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of Opioid and Benzodiazepine Prescriptions for Osteoarthritis. AU - Alamanda,Vignesh K, AU - Wally,Meghan K, AU - Seymour,Rachel B, AU - Springer,Bryan D, AU - Hsu,Joseph R, AU - ,, Y1 - 2020/06/11/ PY - 2018/08/13/received PY - 2019/05/21/accepted PY - 2019/5/28/pubmed PY - 2020/10/7/medline PY - 2019/5/26/entrez SP - 1081 EP - 1086 JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) VL - 72 IS - 8 N2 - OBJECTIVE: Opioids and benzodiazepines are commonly used for management of osteoarthritis, despite evidence-based recommendations to the contrary. This study aimed to quantify the prevalence of opioid and benzodiazepine prescribing for osteoarthritis. Additionally, we aimed to characterize risk factors for prescription drug misuse, abuse, and diversion among this population. METHODS: We conducted a descriptive analysis of adult outpatient encounters with a primary diagnosis of osteoarthritis during a 1-year period at a large health care system, excluding cancer and outpatient procedures. Demographic data, prescription data, and patient-specific risk factors were collected. Descriptive analysis was conducted to characterize arthritis patients who received and did not receive prescription opioids. RESULTS: During 1 year, our system had 31,123 outpatient encounters for osteoarthritis. Opioids and benzodiazepines were prescribed for nearly 27% of the encounters (n = 8,420). In all, 43% of the encounters involved patients age ≥65 years. Hydrocodone-acetaminophen was the most common medication prescribed (34.3%). Most prescriptions were written by pain specialists (53%). A total of 35.5% of patients had a risk factor for prescription misuse, the most prevalent being early refill and a history of receiving ≥3 prescriptions in the past month. CONCLUSION: Prescriptions for opioids and benzodiazepines continue to be written for osteoarthritis. These prescriptions may pose a risk for adverse outcomes since >1 in 5 patients receiving prescriptions had a risk factor for misuse. Continued efforts to improve compliance with evidence-based guidelines as well as multimodal and alternative pain management pathways are critical to help curb the use of opioids for management of osteoarthritis-related pain. LEVEL OF EVIDENCE: level IV. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/31127868/Prevalence_of_Opioid_and_Benzodiazepine_Prescriptions_for_Osteoarthritis_ L2 - https://doi.org/10.1002/acr.23933 DB - PRIME DP - Unbound Medicine ER -