Tags

Type your tag names separated by a space and hit enter

Opioid prescriptions in patients with osteoarthritis: a population-based cohort study.
Rheumatology (Oxford). 2020 Sep 01; 59(9):2462-2470.R

Abstract

OBJECTIVES

To examine the incidence, prevalence and trends for opioid prescriptions in patients with OA. Furthermore, types of opioids prescribed and long-term prescription rates were examined. Finally, the patient characteristics associated with the prescription of opioids were assessed.

METHODS

A population-based cohort study was conducted using the Integrated Primary Care Information database. Incidence and prevalence of opioid prescriptions were calculated for the period 2008-2017. Logistic regression was used to assess which patient characteristics were associated with opioid prescriptions.

RESULTS

In total, 157 904 OA patients were included. The overall prescription rate remained fairly stable, at around 100 incident and 170 prevalent prescriptions per 1000 person years. However, the incident prescription rate for oxycodone increased from 7.1 to 40.7 per 1000 person years and for fentanyl from 4.2 to 7.4 per 1000 person years. The incident prescription rate for paracetamol/codeine decreased from 63.0 to 13.3 per 1000 person years. Per follow-up year, long-term use was found in 3% of the patients with incident OA. Finally, factors associated with more prescriptions were increasing age, OA in ≥2 joint groups [odds ratio (OR) 1.56; 95% CI: 1.51, 1.65] and the presence of other musculoskeletal disorders (OR 4.91; 95% CI: 4.76, 5.05). Men were less likely to be prescribed opioids (OR 0.78; 95% CI: 0.76, 0.80).

CONCLUSION

Prescription rates for opioids remained stable, but types of opioids prescribed changed. Oxycodone and fentanyl were increasingly prescribed, while prescriptions of paracetamol/codeine decreased. Since the benefit of opioids for OA pain is questionable and side effects are common, opioids should be prescribed with caution.

Authors+Show Affiliations

Department of General PracticeErasmus MC, University Medical Center, Rotterdam, The Netherlands.Department of General PracticeErasmus MC, University Medical Center, Rotterdam, The Netherlands.Department of Medical Informatics Erasmus MC, University Medical Center, Rotterdam, The Netherlands.Department of General PracticeErasmus MC, University Medical Center, Rotterdam, The Netherlands.Department of Medical Informatics Erasmus MC, University Medical Center, Rotterdam, The Netherlands.Department of General PracticeErasmus MC, University Medical Center, Rotterdam, The Netherlands. Department of Orthopedics, University Medical Center, Erasmus MC, Rotterdam, The Netherlands.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

31960046

Citation

van den Driest, Jacoline J., et al. "Opioid Prescriptions in Patients With Osteoarthritis: a Population-based Cohort Study." Rheumatology (Oxford, England), vol. 59, no. 9, 2020, pp. 2462-2470.
van den Driest JJ, Schiphof D, de Wilde M, et al. Opioid prescriptions in patients with osteoarthritis: a population-based cohort study. Rheumatology (Oxford). 2020;59(9):2462-2470.
van den Driest, J. J., Schiphof, D., de Wilde, M., Bindels, P. J. E., van der Lei, J., & Bierma-Zeinstra, S. M. A. (2020). Opioid prescriptions in patients with osteoarthritis: a population-based cohort study. Rheumatology (Oxford, England), 59(9), 2462-2470. https://doi.org/10.1093/rheumatology/kez646
van den Driest JJ, et al. Opioid Prescriptions in Patients With Osteoarthritis: a Population-based Cohort Study. Rheumatology (Oxford). 2020 Sep 1;59(9):2462-2470. PubMed PMID: 31960046.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opioid prescriptions in patients with osteoarthritis: a population-based cohort study. AU - van den Driest,Jacoline J, AU - Schiphof,Dieuwke, AU - de Wilde,Marcel, AU - Bindels,Patrick J E, AU - van der Lei,Johan, AU - Bierma-Zeinstra,Sita M A, PY - 2019/10/03/received PY - 2019/11/29/revised PY - 2020/1/22/pubmed PY - 2021/1/20/medline PY - 2020/1/22/entrez KW - analgesics KW - opioids KW - osteoarthritis KW - pain SP - 2462 EP - 2470 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 59 IS - 9 N2 - OBJECTIVES: To examine the incidence, prevalence and trends for opioid prescriptions in patients with OA. Furthermore, types of opioids prescribed and long-term prescription rates were examined. Finally, the patient characteristics associated with the prescription of opioids were assessed. METHODS: A population-based cohort study was conducted using the Integrated Primary Care Information database. Incidence and prevalence of opioid prescriptions were calculated for the period 2008-2017. Logistic regression was used to assess which patient characteristics were associated with opioid prescriptions. RESULTS: In total, 157 904 OA patients were included. The overall prescription rate remained fairly stable, at around 100 incident and 170 prevalent prescriptions per 1000 person years. However, the incident prescription rate for oxycodone increased from 7.1 to 40.7 per 1000 person years and for fentanyl from 4.2 to 7.4 per 1000 person years. The incident prescription rate for paracetamol/codeine decreased from 63.0 to 13.3 per 1000 person years. Per follow-up year, long-term use was found in 3% of the patients with incident OA. Finally, factors associated with more prescriptions were increasing age, OA in ≥2 joint groups [odds ratio (OR) 1.56; 95% CI: 1.51, 1.65] and the presence of other musculoskeletal disorders (OR 4.91; 95% CI: 4.76, 5.05). Men were less likely to be prescribed opioids (OR 0.78; 95% CI: 0.76, 0.80). CONCLUSION: Prescription rates for opioids remained stable, but types of opioids prescribed changed. Oxycodone and fentanyl were increasingly prescribed, while prescriptions of paracetamol/codeine decreased. Since the benefit of opioids for OA pain is questionable and side effects are common, opioids should be prescribed with caution. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/31960046/Opioid_prescriptions_in_patients_with_osteoarthritis:_a_population_based_cohort_study_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/kez646 DB - PRIME DP - Unbound Medicine ER -