Risk Prescriptions of Strong Opioids in the Treatment of Chronic Non-Cancer Pain by Primary Care Physicians in Catalonia: Opicat Padris Project

February 16, 2022

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Publicated to: International Journal of Environmental Research and Public Health. 19 (3): 1652- - 2022-02-01 19(3), DOI: 10.3390/ijerph19031652

Authors:

Perelló-Bratescu, A; Dursteler, C; Alvarez-Carrera, MA; Granés, L; Kostov, B; Sisó-Almirall, A

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Affiliations

Consorci Atencio Primaria Salut Barcelona Esquera, Primary Care Ctr Corts, Barcelona 08028, Spain - Author

Hosp Clin Barcelona, Anaesthesiol Dept, Pain Med Sect, Barcelona 08036, Spain - Author

Hosp Clin Barcelona, Prevent Med & Epidemiol Dept, Barcelona 08036, Spain - Author

IDIBAPS, Primary Healthcare Transversal Res Grp, Barcelona 08036, Spain - Author

Parc Sanitari Pere Virgili, Larrard Primary Hlth Ctr, Barcelona 08024, Spain - Author

Parc Sanitari Pere Virgili, Pharm Serv, Barcelona 08023, Spain - Author

Univ Barcelona, Med Fac, Med Dept, Barcelona 08036, Spain - Author

Univ Barcelona, Med Fac, Surg Dept, Barcelona 08036, Spain - Author

Abstract

The prescription of strong opioids (SO) for chronic non-cancer pain (CNCP) is steadily increasing. This entails a high risk of adverse effects, a risk that increases with the concomitant prescription of SO with central nervous system depressant drugs and with the use of SO for non-recommended indications. In order to examine this concomitant risk prescription, we designed a descriptive, longitudinal, retrospective population-based study. Patients aged >= 15 years with a continued SO prescription for >= 3 months during 2013-2017 for CNCP were included. Of these, patients who had received concomitant prescriptions of SO and risk drugs (gabapentinoids, benzodiazepines and antidepressants) and those who had received immediate-release fentanyl (IRF) were selected. The study included 22,691 patients; 20,354 (89.7%) patients received concomitant risk prescriptions. Men and subjects with a higher socioeconomic status received fewer concomitant risk prescriptions. Benzodiazepines or Z-drugs were prescribed concomitantly with SO in 15,883 (70%) patients, antidepressants in 14,932 (65%) and gabapentinoids in 11,267 (49%), while 483 (21.32%) patients received IRF (2266 prescriptions in total) without a baseline SO. In conclusion, our study shows that a high percentage of patients prescribed SO for CNCP received concomitant prescriptions with known risks, as well as IRF for unauthorized indications.

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Keywords

analgesicsbig datachronic paindrug combinationsinappropriate prescribingopioid-related disordersopioidspharmacoepidemiologyphysiciansprimary careAdolescentAlprazolamAmfebutamoneAmitriptylineAnalgesic agentAnalgesicsAnalgesics, opioidAntidepressant agentAvaluació del risc per la salutBenzodiazepine derivativeBig dataBromazepamCataloniaChronic painCitalopramClinical practiceClomipramineClorazepateControlled studyDescriptive researchDiazepamDisease treatmentDrugDrug classificationDrug combinationDrug combinationsDrug indicationDrug prescribingDrug releaseDuloxetineEscitalopramFemaleFentanylFluoxetineGabapentinGabapentinoid derivativeGeneral practitionerHealth riskHealth risk assessmentHealth statusHealth workerHumanHumansInappropriate prescribingKetazolamLongitudinal studyLorazepamLormetazepamMajor clinical studyMaleMens healthMianserinMidazolamMiddle agedMirtazapineMonotherapyNarcotic analgesic agentOlderOpiacisOpiate derivativeOpioid-related disordersOpioid?related disordersOpioidsPain treatmentParoxetinePharmacoepidemiologyPhysiciansPhysicians, primary carePopulation researchPractice patterns, physicians'PregabalinPrescriptionPrescriptionsPrimary carePrimary medical carePyridoxineRetrospective studiesRetrospective studyRisk assessmentRisk benefit analysisSertralineSide effectSocial statusSpainSulpirideTractament del dolorUnclassified drugVenlafaxineVery elderlyZolpidem

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal International Journal of Environmental Research and Public Health due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position , thus managing to position itself as a Q2 (Segundo Cuartil), in the category Health, Toxicology and Mutagenesis.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-04:

WoS: 3
Scopus: 4
Europe PMC: 1

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Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Perelló Bratescu, Aina) and Last Author (Sisó Almirall, Antoni).

the author responsible for correspondence tasks has been Sisó Almirall, Antoni.

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Awards linked to the item

APB received funding from the Sociedad Espanola de Medicina Familiar y Comunitaria-semFYC- in the form of a grant for the completion of doctoral theses, Isabel Fernandez 2019. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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