title: Prevalence of opioid dispensings and concurrent gastrointestinal medications in Quebec.
abstract: BACKGROUND
  Opioids are frequently prescribed for moderate to severe pain. A side effect of opioid usage is the inhibition of gastrointestinal (GI) motility, known as opioid-induced bowel dysfunction (OBD). OBD is typically treated prophylactically with laxatives and/or acid suppressants.
  
  
  OBJECTIVE
  The present study describes the prevalence of outpatient opioid dispensing, opioid patient demographics, and concomitant dispensing of opioids and GI medications in the Quebec Public Prescription Drug Insurance Plan in 2005.
  
  
  METHODS
  Using a retrospective cohort design, opioid dispensings were identified using claims and reimbursement data. Laxative and acid suppressant dispensings were also identified. Concurrent use was defined as having at least one 'GI medication-exposed day' overlapping an 'opioid-exposed day'.
  
  
  RESULTS
  More than 11% of the drug plan population was dispensed an opioid in 2005, and dispensings increased with age. Approximately two-thirds of patients who received an opioid were given codeine. Approximately one-third of opioid patients were concomitantly dispensed a GI medication, yet only 2% were dispensed a laxative.
  
  
  CONCLUSIONS
  Although the GI side effects of opioids are well known, these side effects appear to increase with age and duration of opioid use. Opioid-related side effects, particularly OBD, should be effectively managed so as not to lead to the cessation of opioid therapy.
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline, Collegeville, PA 19426-0989, USA. rachel.e.williams@gsk.com
authors.forename: R E
authors.initials: RE
authors.lastname: Williams
authors.forename: N
authors.initials: N
authors.lastname: Bosnic
authors.forename: C T
authors.initials: CT
authors.lastname: Sweeney
authors.forename: A W
authors.initials: AW
authors.lastname: Duncan
authors.forename: K B
authors.initials: KB
authors.lastname: Levine
authors.forename: M
authors.initials: M
authors.lastname: Brogan
authors.forename: S F
authors.initials: SF
authors.lastname: Cook
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects; D000863:Antacids / Q000627:therapeutic use; D003061:Codeine / Q000627:therapeutic use; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization; D005260:Female; D005765:Gastrointestinal Agents; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data; D007356:Insurance, Pharmaceutical Services / Q000706:statistics & numerical data; D054368:Laxatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs; D010045:Outpatients / Q000706:statistics & numerical data; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000863:Antacids; D005765:Gastrointestinal Agents; D054368:Laxatives; D004366:Nonprescription Drugs; D003061:Codeine