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Researchers Identify 4 Predictors of Transition to Chronic Opioid Use Based on Readily Available Opioid Regimen and Patient Factors

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Cranbury, NJ, February 27, 2018--In a new study published in February 2018 in American Health & Drug Benefits, researchers have identified opioid prescription characteristics that may increase the patient’s risk for becoming a chronic user of opioid therapy. View the article here.

In light of the current opioid epidemic in the United States, it is important to understand the use of chronic opioid therapy among working-age adults, who may have unique and negative consequences, such as missed work days, loss of employment, and decreased productivity, in addition to complications associated with opioid use (eg, high economic burden from increased emergency department, inpatient, and other health services utilization).

This is the first study to identify incident chronic opioid use among working-age adults who initiate opioid therapy. This is an important group, because of the potential impact on their productivity and their increased likelihood to use opioid therapy when they experience pain.

The 4 leading predictors identified that increase the risk for transitioning to chronic opioid use by at least 4 times are:

  1. The drug’s duration of action
  2. Type of parent opioid compounds
  3. The patient’s drug use disorder
  4. Pain conditions

In this study, adults who were prescribed long-acting opioids as opposed to immediate-release opioids had the highest likelihood of transitioning to chronic opioid therapy use.

In addition, the rates of patients who became chronic opioid users were higher in Ohio, West Virginia, Kentucky, Mississippi, and Nevada than in other states.

“These findings suggest that the likelihood of an individual’s transitioning to chronic opioid use can be predicted by information that is readily available to providers in a clinical setting, such as the initial opioid regimen characteristics, the patient’s history of drug use disorder, and the medical conditions associated with pain,” said Douglas Thornton, PharmD, PhD, lead investigator and Assistant Professor, College of Pharmacy, Department of Pharmaceutical Health Outcomes and Policy, University of Houston, TX.

“The very timely article by Thornton and colleagues can play a role in addressing our current epidemic of opioid abuse,” said Albert Tzeel, MD, MHSA, CPE, FAAPL, Regional Medical Director, Senior Products, North Florida, Humana, Tampa, in his accompanying commentary. “It is well known that prescribing opioid medications, especially those with protracted durations of action or over a longer time frame, increases the risk for an individual using these medications to become addicted to and/or physiologically dependent on them. It is in this realm that the article by Thornton and colleagues becomes extremely valuable,” Dr. Tzeel added.

The investigators from the University of Houston (D. Thornton), West Virginia University (N. Dwibedi, V. Scott, C. Ponte, and U. Sambamoorthi), University of California San Diego (D. Ziedonis), and Northwestern University (N. Sambamoorthi), note that “the importance of these factors could change, and the overall prediction improved, if and when other types of information are added to the data. Further intervention research, working with patients, prescribers, and healthcare payers, is needed to optimize opioid use and prevent unnecessary adverse events.”

About American Health & Drug Benefits
American Health & Drug Benefits®: The Peer-Reviewed Journal for Real-World Evidence in Benefit Design™ is a peer-reviewed journal founded on the concept that the economic value of a therapy is of equal importance to its clinical outcomes, and this combination serves as the basis for insurance coverage decisions and benefit designs. The journal offers a forum for stakeholder integration and collaboration toward the promotion of value-based healthcare by integrating the clinical, business, and policy issues related to drug therapy, and is published by Amplity Medical Communications.



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Last modified: April 10, 2023