King's College London

Research portal

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

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)3172-3181
Number of pages10
JournalBritish Journal of Clinical Pharmacology
Volume88
Issue number7
Early online date7 Feb 2022
DOIs
Accepted/In press7 Dec 2021
E-pub ahead of print7 Feb 2022
PublishedJul 2022

Bibliographical note

Funding Information: King's College London and the School of Population Health & Environmental Sciences hosted MN for this project and the duration of his ACF post. The NIHR Research Design Service helped with statistical analysis. This work was supported by the National Institute for Health Research Biomedical Research Center at Guy's and St Thomas' National Health Service Foundation Trust and King's College London. M.N.'s Fellowship is funded by the National Institute of Health Research (NIHR) and Health Education England. Lambeth DataNet (LDN) is funded through a grant from the Guy's and St Thomas' Hospital Charity. Funding Information: King's College London and the School of Population Health & Environmental Sciences hosted MN for this project and the duration of his ACF post. The NIHR Research Design Service helped with statistical analysis. This work was supported by the National Institute for Health Research Biomedical Research Center at Guy's and St Thomas' National Health Service Foundation Trust and King's College London. M.N.'s Fellowship is funded by the National Institute of Health Research (NIHR) and Health Education England. Lambeth DataNet (LDN) is funded through a grant from the Guy's and St Thomas' Hospital Charity. Publisher Copyright: © 2022 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

King's Authors

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.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454