ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 0534

National Variation and Factors Associated with Long-term Opioid Use for Non-cancer Pain in the First Year of Use

Meghna Jani1, Belay Yimer1, Therese Sheppard1, Mark Lunt1 and William Dixon1, 1Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, United Kingdom

Meeting: ACR Convergence 2020

Keywords: Epidemiology, pain, Pharmacoepidemiology

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Saturday, November 7, 2020

Session Title: Epidemiology & Public Health Poster II: OA, Osteoporosis, & Other Rheumatic Disease

Session Type: Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Physician prescribing behaviour has been described as a key driver of rising opioid prescriptions and long-term opioid use. However, the effect of prescribers requires interpretation within context. No studies have investigated the extent to which regions, practices, prescribers, vary in opioid prescribing by considering this hierarchy together, whilst accounting for case-mix. Objectives: (i) quantify and identify risk factors for the transition from new-users to long-term opioid users (ii) quantify variation of long-term use attributed to region, practice, prescriber, accounting for patient mix and chance variation.

Methods: We conducted a retrospective observational study between 2006-2017 using Clinical Practice Research Datalink. New users of opioids, ≥18 years, without cancer were identified. Long-term opioid use was defined as ≥3 opioid prescriptions within a 90-day period from index date, or ≥1 opioid prescription lasting at least 90-days in the first year. A multi-level random-effects logistic regression model was used to examine the association of patient characteristics with the odds of becoming a long-term opioid-user. To examine variation in opioid use amongst prescribers, GP-practices and region after adjusting for case-mix, we used a nested random-effect structure. A ‘high-risk’ region, prescriber or practice was defined as those where the entire adjusted 95% CI lay above population average.

Results: 1,968,742 new opioid users were included; 14.6% transitioned to long-term use. In the fully-adjusted model, factors associated with higher-odds of long-term use included older-age, deprivation, fibromyalgia, rheumatological conditions, higher morphine milligram equivalents (MME)/day at initiation and prior surgery (Table). After adjustment for case-mix, the North-West, Yorkshire and South-West were found to be high-risk regions for long-term use. 103 practices (25.6%) and 540 prescribers (3.5%) were associated with a significantly higher-risk of long-term use. The odds of becoming a long-term user for patients belonging to these prescribers reached up to >3.5 times than the population average.

Conclusion: Prescribing factors, age, deprivation and conditions including fibromyalgia and rheumatological conditions were associated with higher odds of long-term opioid use. In the first UK study evaluating long-term opioid prescribing with patient-level characteristics adjustment, variation in regions, especially practices and prescribers were observed. Our findings support greater calls for action to reduce practice/prescriber variation by promoting safe practice in opioid-prescribing.

Factors associated with long term opioid use using a multi-level model accounting for clustering of individuals within prescriber, practice and region


Disclosure: M. Jani, None; B. Yimer, None; T. Sheppard, None; M. Lunt, None; W. Dixon, Google, 1, Bayer, 1.

To cite this abstract in AMA style:

Jani M, Yimer B, Sheppard T, Lunt M, Dixon W. National Variation and Factors Associated with Long-term Opioid Use for Non-cancer Pain in the First Year of Use [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/national-variation-and-factors-associated-with-long-term-opioid-use-for-non-cancer-pain-in-the-first-year-of-use/. Accessed February 28, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/national-variation-and-factors-associated-with-long-term-opioid-use-for-non-cancer-pain-in-the-first-year-of-use/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.