Existing opioid prescriptions drive increase in prescription rates in GI conditions
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Opioid prescriptions rates for gastrointestinal conditions continue to increase, with renewals of existing prescriptions being the main driver, according to a study in the American Journal of Gastroenterology.
“In this population-based national study, opioid prescription rates for GI conditions have continued to increase in recent years despite mounting public pressures to address the opioid epidemic,” Wendi G. LeBrett, MD, from the department of medicine and Vatche & Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at the University of California, Los Angeles, and colleagues wrote. “Renewals of existing opioid prescriptions was the primary driver of opioid prescription volume for GI conditions.”
LeBrett and colleagues used the National Ambulatory Medical Care Survey from 2006 to 2016 to perform a repeated cross-sectional study of 12,170 visits with a primary gastrointestinal diagnosis. Investigators calculated the national estimate for opioid prescriptions for GI disease. They analyzed temporal trends with joinpoint regression. Factors correlated with opioid prescriptions were assessed with multivariable logistic regression.
“Opioid prescription rates for gastrointestinal disease increased by 0.5% per year from 2006 to 2016 (P = .04),” LeBrett and colleagues wrote.
For GI visits, results showed the opioid prescription rate was 10.1% (95% CI, 9%–11.2%). Investigators reported the opioid prescription rates were highest for chronic pancreatitis (25.1%) and chronic liver disease (13.9%) visits.
According to researchers, 71% of opioid prescriptions were continuations of a previous prescription. Among the characteristics correlated with continued opioid prescriptions were rural location (adjusted OR = 1.46; 95% CI, 1.11–1.93), depression (aOR = 1.83; 95% CI, 1.33–2.53), and Medicaid insurance (aOR = 1.57; 95% CI, 1.15–2.13).
“The findings of our study highlight the urgent need for changes in clinical practice to reduce opioid use in the management of GI disease,” the researchers wrote. “Deescalating chronic opioid use, advancing alternative nonopioid pharmacologic options, expanding psychological interventions, and targeting GI conditions with higher levels of inappropriate opioid use should be considered in future efforts to decrease opioid use for GI disease.”
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