Determinants of long‐term opioid prescribing in an urban population: A cross‐sectional study

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Abstract

Background
Opioid prescribing has more than doubled in the UK between 1998 and 2016. Potential adverse health implications include dependency, falls and increased health expenditure.

Aim
To describe the predictors of long-term opioid prescribing (LTOP) (≥3 opioid prescriptions in a 90-day period).

Design and setting
A retrospective cross-sectional study in 41 general practices in South London.

Method
Multi-level multivariable logistic regression to investigate the determinants of LTOP.

Results
Out of 320 639 registered patients ≥18 years, 2679 (0.8%) were identified as having LTOP. Patients were most likely to have LTOP if they had ≥5 long-term conditions (LTCs) (adjusted odds ratio [AOR] 36.5, 95% confidence interval [CI] 30.4-43.8) or 2-4 LTCs (AOR 13.8, CI 11.9-16.1) in comparison to no LTCs, were ≥75 years compared to 18-24 years (AOR 12.31, CI 7.1-21.5), were smokers compared to nonsmokers (AOR 2.2, CI 2.0-2.5), were female rather than male (AOR 1.9, CI 1.7-2.0) and in the most deprived deprivation quintile (AOR 1.6, CI 1.4-1.8) compared to the least deprived. In a separate model examining individual LTCs, the strongest associations for LTOP were noted for sickle cell disease (SCD) (AOR 18.4, CI 12.8-26.4), osteoarthritis (AOR 3.0, CI 2.8-3.3), rheumatoid arthritis (AOR 2.8, CI 2.2-3.4), depression (AOR 2.6, CI 2.3-2.8) and multiple sclerosis (OR 2.5, CI 1.4-4.4).

Conclusion
LTOP was significantly higher in those aged ≥75 years, with multimorbidity or specific LTCs: SCD, osteoarthritis, rheumatoid arthritis, depression and multiple sclerosis. These characteristics may enable the design of targeted interventions to reduce LTOP.
Original languageEnglish
Pages (from-to)3172-3181
Number of pages10
JournalBritish Journal of Clinical Pharmacology
Volume88
Issue number7
Early online date7 Feb 2022
DOIs
Publication statusPublished - Jul 2022

Keywords

  • Pharmacology (medical)
  • Pharmacology

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