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Opioid prescribing patterns for acute pain.

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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.