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Most opioid recipients take immediate-release formulations
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The majority of patients receiving opioid analgesics used immediate-release formulations, regardless of the duration of use, according to findings recently published in JAMA Network Open.
“Recently, many professional societies, states, and medical systems have recommended or required limited prescribing of extended-release/long-acting formulations for both acute pain and chronic pain. Additionally, the [CDC] recommends that clinicians initially prescribe immediate-release formulations rather than [extended-release/long-acting] formulations for chronic pain,” Catherine S. Hwang, MSPH, of the University of Washington School of Medicine and colleagues wrote.
“However, little information exists regarding the frequency with which patients add or switch to [extended-release/long-acting] formulations opioid analgesic therapy after long-term [immediate-release] opioid analgesic use,” they added.
Researchers identified more than 169.2 million patients who received opioid analgesics from 2003 through 2014, using records in the IQVIA Health Vector One: Data Extract Tool.
Hwang and colleagues found more than 168.3 million patients filled an immediate-release formulation and 10.2 million patients filled extended-release/long-acting formulations. Those who received extended-release formulations (72%) were more likely to be aged 45 and older vs. those who received immediate-release formulations (46%).
Other findings included:
- Median episode duration was 30 days (interquartile range = 21 to 74 days) for those who received extended-release/long-acting formulations vs. 5 days (interquartile range = 3 to 10 days) for those who received immediate-release formulations;
- Seven percent of patients received immediate-release formulations for 90 days or more, vs. 30% of patients who received extended-release long-acting formulations;
- From Jan. 1, 2003 to Dec. 31, 2014, the number of patients receiving long-term immediate-release opioid analgesic therapy who added an extended-release/long-acting formulation declined from 3.8% to 1.8%.
- From Jan. 1, 2003 to Dec. 31, 2014, the number of patients who switched to an extended-release/long-term formulations declined from 1% to 0.5%.
“Our results support the many efforts federal agencies have undertaken in recent years to enhance the safety and appropriateness of prescribing [immediate-release] opioid analgesics,” Hwang and colleagues wrote.
“Other areas of future work include examining adding and switching patterns among individual opioid analgesic active moieties and products. Furthermore, better understanding changes in prescribed [immediate-release] and [extended-release/long-acting] opioid analgesic doses over time, reasons for choosing one formulation over another, and the generalizability of these findings to all settings of care will help guide opioid analgesic policies,” they added. – by Janel Miller
Disclosure: Hwang reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
