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Physician Prescribing Patterns and Risk of Future Long-Term Opioid Use Among Patients With Rheumatoid Arthritis: A
Yvonne C Lee1, Bing Lu2, Hongshu Guan2
1Northwestern University Feinberg School of Medicine, Chicago, Illinois, and Brigham and Women's Hospital, Boston, Massachusetts.
Arthritis & Rheumatology (Hoboken, N.J.)
|February 28, 2020
Summary
Opioid prescribing rates for rheumatoid arthritis (RA) patients vary significantly. Higher baseline opioid prescribing by physicians strongly predicts future long-term opioid use in RA patients, even after accounting for patient factors.
Area of Science:
- Rheumatology
- Pain Management
- Health Services Research
Background:
- Rheumatoid arthritis (RA) management often involves pain control, with opioids sometimes used.
- Understanding variations in opioid prescribing patterns is crucial for patient safety and effective pain management.
- Long-term opioid use poses significant risks, including addiction and overdose.
Purpose of the Study:
- To assess the variability of opioid prescribing rates among physicians treating patients with rheumatoid arthritis (RA) in the US.
- To determine if initial opioid prescribing rates predict the likelihood of patients developing long-term opioid use.
Main Methods:
- Patients with RA were identified from the Corrona RA Registry.
- Baseline opioid prescribing rates were calculated per physician.
- Generalized linear mixed models were used to estimate odds ratios for long-term opioid use.
Main Results:
- Opioid prescription rates varied widely among physicians.
- Patients treated by physicians with moderate (OR 1.89) and high (OR 2.01) baseline opioid prescribing rates had significantly higher odds of long-term opioid use compared to those with very low rates.
- No significant difference in long-term opioid use was observed for patients of low-intensity prescribers (OR 1.16).
Conclusions:
- Baseline opioid prescribing patterns are a significant predictor of future long-term opioid use in RA patients.
- Physician prescribing habits play a critical role in the trajectory of opioid use for RA patients.
- Interventions targeting physician prescribing behavior may help mitigate long-term opioid use in this population.
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