Risk Prescriptions of Strong Opioids in the Treatment of Chronic Non-Cancer Pain by Primary Care Physicians in Catalonia: Opicat Padris Project

Aina Perelló-Bratescu, Christian Dürsteler, Maria Asunción Álvarez-Carrera, Laura Granés, Belchin Kostov and Antoni Sisó-Almirall
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Aina Perelló-Bratescu: Larrard Primary Health Center, Parc Sanitari Pere Virgili, 08024 Barcelona, Spain
Christian Dürsteler: Pain Medicine Section, Anaesthesiology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
Maria Asunción Álvarez-Carrera: Pharmacy Service, Parc Sanitari Pere Virgili, 08023 Barcelona, Spain
Laura Granés: Preventive Medicine and Epidemiology Department, Hospital Clinic Barcelona, 08036 Barcelona, Spain
Belchin Kostov: Primary Healthcare Transversal Research Group, IDIBAPS, 08036 Barcelona, Spain
Antoni Sisó-Almirall: Primary Healthcare Transversal Research Group, IDIBAPS, 08036 Barcelona, Spain

IJERPH, 2022, vol. 19, issue 3, 1-10

Abstract: The prescription of strong opioids (SO) for chronic non-cancer pain (CNCP) is steadily increasing. This entails a high risk of adverse effects, a risk that increases with the concomitant prescription of SO with central nervous system depressant drugs and with the use of SO for non-recommended indications. In order to examine this concomitant risk prescription, we designed a descriptive, longitudinal, retrospective population-based study. Patients aged ≥15 years with a continued SO prescription for ≥3 months during 2013–2017 for CNCP were included. Of these, patients who had received concomitant prescriptions of SO and risk drugs (gabapentinoids, benzodiazepines and antidepressants) and those who had received immediate-release fentanyl (IRF) were selected. The study included 22,691 patients; 20,354 (89.7%) patients received concomitant risk prescriptions. Men and subjects with a higher socioeconomic status received fewer concomitant risk prescriptions. Benzodiazepines or Z-drugs were prescribed concomitantly with SO in 15,883 (70%) patients, antidepressants in 14,932 (65%) and gabapentinoids in 11,267 (49%), while 483 (21.32%) patients received IRF (2266 prescriptions in total) without a baseline SO. In conclusion, our study shows that a high percentage of patients prescribed SO for CNCP received concomitant prescriptions with known risks, as well as IRF for unauthorized indications.

Keywords: analgesics; opioids; opioid-related disorders; inappropriate prescribing; chronic pain; physicians; primary care; drug combinations; big data; pharmacoepidemiology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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