Opioid prescribing patterns for acute pain.

Area of Science:

• Pain Management
• Pharmacology
• Public Health

Background:

• Opioid prescribing patterns for acute pain can influence long-term use.
• Identifying at-risk patients early is crucial for effective pain management.
• Veterans Affairs administrative data offers a robust source for analyzing prescribing trends.

Purpose of the Study:

• To identify distinct clusters of early opioid prescribing patterns in patients with acute pain.
• To determine the association between these identified prescribing patterns and the risk of progressing to long-term opioid use.

Main Methods:

• Latent Class Analysis (LCA) was used to categorize opioid prescribing patterns within 30 days of initial prescription.
• A cohort of outpatients with acute pain and minimal prior opioid use was analyzed using national administrative data.
• Log-binomial regression adjusted for confounding variables to compare the risk of long-term opioid use across LCA classes.

Main Results:

• Three distinct opioid prescribing patterns were identified: immediate/brief/low-dose, delayed/longer/low-dose, and delayed/moderate/high-dose.
• Patients in the delayed/longer/low-dose class had a 7.76 times higher risk of long-term opioid use.
• Patients in the delayed/moderate/high-dose class had a 6.81 times higher risk of long-term opioid use compared to those not receiving acute opioid prescriptions.

Conclusions:

• Early opioid prescribing clusters can identify patients at higher risk for long-term opioid dependence.
• These findings can inform targeted interventions for enhanced pain care.
• Early identification may reduce future reliance on long-term opioid therapy.