You are here
Incidence and Risk Factors for Progression From Short-term to Episodic or Long-term Opioid Prescribing: A Population-Based Study
Mayo Clinic Proceedings, Volume 90, Issue 7, July 2015, Pages 850 - 856
To determine what proportion of a geographically defined population who receive new opioid prescriptions progresses to episodic or long-term patterns of opioid prescribing and to explore the clinical characteristics associated with patterns of opioid prescribing.
Patients and Methods
Population-based drug prescription records for the population of Olmsted County between January 1 and December 31, 2009, were obtained using the Rochester Epidemiology Project medical records linkage system (N=142,377). All medical records were reviewed for a random sample of 293 patients who had a new (“incident”) prescription for an opioid analgesic in 2009. Patients were followed through their medical records for 1 year after their initial prescription date, with patterns of opioid prescribing categorized as short-term, episodic, or long-term.
Overall, 293 patients received 515 new opioid prescriptions in 2009. Of these, 61 (21%) progressed to an episodic prescribing pattern and 19 (6%) progressed to a long-term prescribing pattern. In multivariable logistic regression analyses, substance abuse was significantly associated (P<.001) with a long-term opioid prescribing pattern as compared with an short-term opioid prescribing pattern. Past or current nicotine use (P=.03) and substance abuse (P=.04) were significantly associated with an episodic or long-term prescribing pattern as compared with a short-term prescribing pattern.
Knowledge of the clinical characteristics associated with the progression of a short-term to an episodic or long-term opioid prescribing pattern could aid in the identification of at-risk patients and provide the basis for developing targeted clinical interventions.
Abbreviations and Acronyms: CCI - Charlson Comorbidity Index, CONSORT - Consortium to Study Opioid Risks and Trends, mPFC - medial prefrontal cortex, OR - odds ratio, PTSD - posttraumatic stress disorder, REP - Rochester Epidemiology Project.
a Department of Anesthesiology, Mayo Clinic, Rochester, MN
b Division of Epidemiology, Department of Health Sciences Research, the Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
c Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, the Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
∗ Correspondence: Address to W. Michael Hooten, MD, Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
Grant Support: This study was made possible by the Rochester Epidemiology Project (grant number R01-AG034676; Principal Investigator: Walter A. Rocca, MD, MPH, and Barbara P. Yawn, MD, MSc).
© 2015 Mayo Foundation for Medical Education and Research, Published by Elsevier B.V.