Associations between naloxone prescribing and opioid overdose among patients with acute and chronic pain conditions.
Aims: To assess whether naloxone prescribing in clinical contexts targeted pain patients most at risk for opioid overdose. Design A retrospective cohort study using data from the Health Facts Database. Setting: Over 600 United States healthcare facilities. Participants: Three patient groups were fol...
| Published in: | Addiction Vol. 117; no. 2; pp. 457 - 472 |
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| Main Authors: | , |
| Format: | research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Feb2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=154579717&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 154579717 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Feb2022 vid: 117 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 154579717 151919143 154579717 154579717 10.1111/add.15643 154579717 ppf: 457 ppct: 15 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Associations between naloxone prescribing and opioid overdose among patients with acute and chronic pain conditions. aug: au: Qeadan, Fares Madden, Erin Fanning affil: Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way Ste A, Salt Lake City UT, 84108,, USA sug: subj: Naloxone Opiate Overdose Analgesics, Opioid Chronic Pain Prescribing Patterns Human Retrospective Design United States Shoulder Fractures Low Back Pain Confidence Intervals Harm Reduction ab: Aims: To assess whether naloxone prescribing in clinical contexts targeted pain patients most at risk for opioid overdose. Design A retrospective cohort study using data from the Health Facts Database. Setting: Over 600 United States healthcare facilities. Participants: Three patient groups were followed for 2 years during 2009 to 2017: individuals with shoulder or long bone fractures (n = 252 424), chronic pain syndrome (CPS) (n = 76 141), or non‐traumatic low back pain (n = 792 956) who received an opioid prescription. Groups were chosen based on previous work. Measurements The outcome was opioid overdose identified by International Classification of Diseases codes (ICDs) and the primary predictor was number of naloxone prescriptions identified by National Drug Codes (NDCs). Findings Opioid overdoses occurred among 0.16% of fracture patients (average follow‐up time to overdose [AFU] = 240 days), 1.28% of CPS patients (AFU = 244 days), and 0.30% low back pain patients (AFU = 264 days). A total of 58 083 bone fracture patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose (hazard ratio [HR] = 1.87, 95% CI = 1.68–2.09), and number of subsequent overdoses (incidence rate ratio [IRR] = 1.89, 95% CI = 1.69–2.12). A total of 19 529 CPS patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose (HR = 1.69, 95% CI = 1.61–1.78) and number of subsequent overdoses (IRR = 1.74, 95% CI = 1.67–1.83). A total of 110 608 low back pain patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose (HR = 1.33, 95% CI = 1.27–1.40) and number of subsequent overdoses (IRR = 1.35, 95% CI = 1.29–1.41). Conclusions: Receiving a naloxone prescription appears to be associated with increased risk of subsequent opioid overdose among patients with acute and chronic pain, suggesting prescribers often identify patients most in need of naloxone. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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