Clinical indications associated with opioid initiation for pain management in Ontario, Canada: a population-based cohort study

Pain
Sachin V PasrichaTara Gomes

Abstract

Concerns over prescription opioids contributing to high levels of opioid use disorder and overdose have led policymakers and clinicians to seek means to reduce inappropriate and high-dose initial prescriptions. To inform such efforts, we sought to describe the clinical indications associated with opioid initiation and the characteristics of the initial prescriptions and patients through a retrospective population-based cohort study. Our cohort included Ontarians initiating prescription opioids for pain management between April 1, 2015, and March 31, 2016. We identified the apparent clinical indication for opioid initiation by linking prescription drug claims to procedural and diagnostic information on health service records on the day of, and 5 days preceding prescription. Outcomes included initial opioid type, prescription duration, and daily dose (in milligram morphine equivalents), stratified either by indication or indication cluster. Among 653,993 individuals, we successfully classified 575,512 (88.0%) people initiating opioids into 23 clinical indications in 6 clusters: dental (23.2%); postsurgical (17.4%); musculoskeletal (12.0%); trauma (11.2%); cancer/palliative care (6.5%); and other less frequent indications (17.7%)....Continue Reading

References

Jan 20, 2010·Annals of Internal Medicine·Kate M DunnMichael Von Korff
Apr 13, 2011·Archives of Internal Medicine·Tara GomesDavid N Juurlink
May 11, 2012·Headache·Stewart J Tepper
Jan 16, 2013·JAMA Internal Medicine·Tara GomesMuhammad M Mamdani
May 25, 2013·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·G Casucci, S Cevoli
May 25, 2013·BMJ : British Medical Journal·Aleesa A CarterMuhammad M Mamdani
Oct 11, 2013·The Journal of Clinical Psychiatry·Mark OlfsonCarlos Blanco
Dec 23, 2014·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Stephen G HenryAna-Maria Iosif
Dec 18, 2015·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Jenna L McCauleyKathleen T Brady
Mar 18, 2016·MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports·Deborah DowellRoger Chou
Jun 15, 2016·JAMA : the Journal of the American Medical Association·Wayne A RayC Michael Stein
Mar 17, 2017·MMWR. Morbidity and Mortality Weekly Report·Anuj ShahBradley C Martin
May 10, 2017·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Jason W BusseGordon H Guyatt
Jul 18, 2017·The Journal of Pain : Official Journal of the American Pain Society·Anuj ShahBradley C Martin

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Citations

Aug 25, 2018·Expert Review of Clinical Pharmacology·Mina Tadrous
Jul 25, 2019·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Jessica C YoungNabarun Dasgupta
Oct 2, 2019·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Jenny LauPatricia Murphy-Kane
Feb 15, 2020·Pharmacoepidemiology and Drug Safety·Jennifer BethellHannah Wunsch
Nov 2, 2019·Trauma Surgery & Acute Care Open·Celina NahanniAvery B Nathens
Sep 6, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Aaron GazendamOlufemi R Ayeni
Sep 5, 2019·JAMA Network Open·Karim S LadhaHannah Wunsch
Mar 7, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Anaïs LacasseAlain Vanasse
Dec 11, 2020·Pharmacoepidemiology and Drug Safety·Tara GomesDavid N Juurlink
Dec 15, 2019·The Journal of Pain : Official Journal of the American Pain Society·Debbie Ehrmann FeldmanRichard L Nahin
May 28, 2019·Journal of the American College of Surgeons·Carlos A PelaezMarizen R Ramirez
Feb 27, 2021·The Journal of the American Dental Association·Douglas R Oyler, Craig S Miller
Mar 22, 2021·American Journal of Preventive Medicine·Tonya J CampbellTara Gomes
Mar 31, 2021·American Journal of Surgery·Jackly M JuprasertHeather L Yeo
Apr 6, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Sibtain AnwarBenjamin O'Brien
Aug 18, 2021·Population Health Management·Shivani R KhanTheresa V Brown
Sep 4, 2021·Plastic and Reconstructive Surgery. Global Open·Banafsheh Sharif-AskaryDavid H Song

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