Use of prescription opioids among patients with rheumatic diseases compared to patients with hypertension in the USA: a retrospective cohort study.
Adult
Analgesics, Opioid
/ therapeutic use
Drug Prescriptions
/ statistics & numerical data
Female
Follow-Up Studies
Humans
Hypertension
/ drug therapy
Incidence
Male
Middle Aged
Opioid-Related Disorders
/ epidemiology
Prognosis
Retrospective Studies
Rheumatic Diseases
/ drug therapy
Risk Factors
Time Factors
United States
/ epidemiology
ankylosing spondylitis
opioid analgesics
psoriatic arthritis
rheumatoid arthritis
systemic lupus erythematosus
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
19 06 2019
19 06 2019
Historique:
entrez:
22
6
2019
pubmed:
22
6
2019
medline:
9
6
2020
Statut:
epublish
Résumé
Long-term opioid prescribing has increased amid concerns over effectiveness and safety of its use. We examined long-term prescription opioid use among patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), psoriatic arthritis (PsA) and ankylosing spondylitis (AS), compared with patients with hypertension (HTN). We used Truven MarketScan, a US commercial claims database (2003-2014) and identified RA, SLE, PsA and AS cohorts, each matched by age and sex to patients with HTN. We compared long-term opioid prescription use during 1 year of follow-up and used multivariable Poisson regression model to estimate the relative risk (RR) of receiving opioid prescriptions based on underlying disease cohort. We identified 181 710 RA (mean age 55.3±13.1, 77% female), 45 834 SLE (47.1±13.1, 91% female), 30 307 PsA (49.7±11.5, 51% female), 7686 AS (44.6±12.0, 39% female) and parallel numbers of age-matched and sex-matched patients with HTN. The proportion of patients receiving long-term opioid prescriptions, and other measures of opioid prescriptions were higher among rheumatic disease cohorts and highest in patients with AS. AS was associated with the highest RR of receiving long-term opioid prescriptions (RR 2.73, 95% CI 2.60 to 2.87) versus HTN, while RRs were 2.21 (2.16 to 2.25) for RA, 1.94 (1.87 to 2.00) for PsA and 1.82 (1.77 to 1.88) for SLE. Patients with rheumatic disease have higher rates of long-term opioid prescriptions, and patients with AS have the highest risk of receiving opioid prescriptions versus patients with HTN. Further studies investigating the effectiveness of disease-targeted treatments on decreasing opioid use in these four rheumatic diseases may provide strategies for reducing prescription opioids.
Identifiants
pubmed: 31221884
pii: bmjopen-2018-027495
doi: 10.1136/bmjopen-2018-027495
pmc: PMC6589005
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e027495Subventions
Organisme : NIAMS NIH HHS
ID : K23 AR071500
Pays : United States
Organisme : NIAMS NIH HHS
ID : R01 AR069557
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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