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...

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Main Authors:	Zin, Che Suraya, Nazar, Nor Ilyani, Abdul Rahman, Norny Syafinaz, Ahmad, Wan Rohaidah, Rani,, Nurul Sahida, Ng, Kim Swan
Format:	Article
Language:	English English
Published:	BMJ Publishing Group Ltd 2019
Subjects:	RM147 Administration of Drugs and Other Therapeutic Agents
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

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spelling	iium-731462020-02-19T03:16:15Z http://irep.iium.edu.my/73146/ Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study Zin, Che Suraya Nazar, Nor Ilyani Abdul Rahman, Norny Syafinaz Ahmad, Wan Rohaidah Rani,, Nurul Sahida Ng, Kim Swan RM147 Administration of Drugs and Other Therapeutic Agents 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. BMJ Publishing Group Ltd 2019 Article PeerReviewed application/pdf en http://irep.iium.edu.my/73146/1/Zin_Patterns%20of%20initial%20prescribingBMJ%20Open_e027203.full.pdf application/pdf en 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 Zin, Che Suraya and Nazar, Nor Ilyani and Abdul Rahman, Norny Syafinaz and Ahmad, Wan Rohaidah and Rani,, Nurul Sahida and Ng, Kim Swan (2019) Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study. BMJ Open, 9 (7). pp. 1-8. E-ISSN 2044-6055 https://bmjopen.bmj.com/content/bmjopen/9/7/e027203.full.pdf 10.1136/bmjopen-2018-027203
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	RM147 Administration of Drugs and Other Therapeutic Agents
spellingShingle	RM147 Administration of Drugs and Other Therapeutic Agents Zin, Che Suraya Nazar, Nor Ilyani Abdul Rahman, Norny Syafinaz Ahmad, Wan Rohaidah Rani,, Nurul Sahida Ng, Kim Swan Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study
description	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.
format	Article
author	Zin, Che Suraya Nazar, Nor Ilyani Abdul Rahman, Norny Syafinaz Ahmad, Wan Rohaidah Rani,, Nurul Sahida Ng, Kim Swan
author_facet	Zin, Che Suraya Nazar, Nor Ilyani Abdul Rahman, Norny Syafinaz Ahmad, Wan Rohaidah Rani,, Nurul Sahida Ng, Kim Swan
author_sort	Zin, Che Suraya
title	Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study
title_short	Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study
title_full	Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study
title_fullStr	Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study
title_full_unstemmed	Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study
title_sort	patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in malaysia: a retrospective cohort study
publisher	BMJ Publishing Group Ltd
publishDate	2019
url	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
first_indexed	2023-09-18T21:43:43Z
last_indexed	2023-09-18T21:43:43Z
_version_	1777413310066458624

Patterns of initial opioid prescription and its association with short- and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study

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