Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study
This study examined opioid prescription initiation patterns and their association with short- and long-term opioid use among opioid-naïve patients. Design This study was designed as a retrospective cohort study. Setting and participants In this study, we analysed the prescription databases of...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English English |
| Published: |
BMJ Publishing Group Ltd
2019
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/73146/ http://irep.iium.edu.my/73146/ http://irep.iium.edu.my/73146/ http://irep.iium.edu.my/73146/1/Zin_Patterns%20of%20initial%20prescribingBMJ%20Open_e027203.full.pdf http://irep.iium.edu.my/73146/7/73146_Patterns%20of%20initial%20opioid%20prescription%20and%20its%20association%20with%20short-term%20and%20long-term%20use%20among%20opioid-naive%20patients%20in%20Malaysia-%20a%20retrospective%20cohort%20study_Scopus.pdf |
| Summary: | This study examined opioid prescription initiation patterns and their association with short- and long-term opioid use among opioid-naïve patients.
Design
This study was designed as a retrospective cohort study.
Setting and participants
In this study, we analysed the prescription databases of tertiary hospitals in Malaysia. This study included patients aged ≥18 years with at least one opioid prescription (buprenorphine, morphine, oxycodone, fentanyl, dihydrocodeine, or tramadol) between 1 January 2011 and 31 December 2016. These patients had no opioid prescriptions in the 365 days prior, and were followed-up for 365 days after the initial opioid prescription.
Main outcome measures
The main outcome measures were the number of short-term (<90 days) and long-term opioid users (≥90 days), initial opioid prescription period, and daily dose.
Results
There were 33752 opioid-naïve patients who received opioid prescriptions (n = 43432 prescriptions) during the study period. Of these, 29824 (88.36%) were short-term opioid users and 3928 (11.64%) were long-term opioid users. The majority of these short- (99.09%) and long-term users (96.18%) received an initial daily opioid dose of <50 mg/day with a short-acting opioid formulation. Short-term opioid users were predominantly prescribed opioids for 3-7 days (59.06%) by the emergency department (ED, 60.56%), while long-term opioid users were primarily prescribed opioids for ≥7 days (91.85%) by non-ED hospital departments (91.8%). The adjusted model showed that the following were associated with long-term opioid use: increasing opioid daily doses, prescription period ≥7 days, and long-acting opioids initiated by non-EDs.
Conclusions
The majority of opioid-naïve patients in tertiary hospital settings in Malaysia were prescribed opioids for short-term use. The progression to long-term use among opioid-naïve patients was attributed to the prescription of higher opioid doses for a longer duration as well as long-acting opioids initiated by non-ED hospital departments. |
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