High number of fibromyalgia patients prescribed opioids without guideline medication

More than half of newly diagnosed fibromyalgia patients were prescribed opioids and not a guideline medication, according to data presented at the American College of Rheumatology Annual Meeting.

Researchers retrospectively studied the medical and pharmacy records from 96,175 patients who had made two or more medical claims with a diagnosis of fibromyalgia (FM) between January 2008 and February 2009. The date of first diagnosis was deemed the index date, and the date of the first medication was considered the treatment date.

All patients had 6 months of pre-index and 12 months of post-index continuous enrollment, no pre-index FM diagnosis and one or more pharmacy claim for an FM guideline medication, which included pregabalin, gabapentin, duloxetine, milnacipran, amitriptyline or selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors. The study’s principal outcomes were indicators that identified patients who filled one or more FM guideline prescription or opioid within a 3-month interval of the 12-month post-index period.

Opioids were prescribed to 56% of patients on the first treatment date, 17% of which were tramadol. Forty-four percent of patients received an FM guideline prescription.

Opioids or opioids with a guideline medication were prescribed to 55% of the patients in the first quarter after diagnosis, but the percentage declined over time, according to the researchers.

More than 20% of patients were treated with only opioids during each quarter studied, and 18% were prescribed an opioid in addition to a FM guideline medication. – by Shirley Pulawski

Reference:

Shah NS, et al. Paper #1882. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.

Disclosure: Shah is employed by Pfizer. Please see the full study for a list of all other authors’ relevant financial disclosures.