title: Opioid Prescribing Patterns and Costs in a Large Group of Patients in Colombia.
abstract: The potential for development of tolerance and dependence and the risk of side effects of opioids make it necessary to monitor their prescribing patterns in order to decrease the morbidity and mortality associated with their continued use. The objective of this study was to determine prescription patterns of opioid medication in a group of patients through a cross-sectional study on a population database of 3.5 million people. Patients with three months of continuous opioid use were identified. Pharmacological, co-medication and cost variables were analyzed. We conducted a multivariate analysis. A total of 7,457 patients were included; 72.1% were women, the mean age was 65.1 years, and 3.8% had a diagnosis of cancer. 10.2% of the patients received opioids in combination therapy. The most prescribed opioids were codeine (57.7%), tramadol (30.9%), and hydrocodone (10.4%). The great majority of patients (91.8%) received pharmacological co-medication with antihypertensive agents (54.4%), statins (38.2%) and acetaminophen (35.4%). The use of other analgesics such as acetaminophen (OR: 1.45, 95% CI: 1.22 -1.75) or nonsteroidal anti-inflammatory drugs (OR: 1.98, 95% CI: 1.60 -2.44) was associated with increased risk of receiving opioids in combination therapy. Prescribing habits of weak agonists and short-acting opioids predominate, mainly in monotherapy and at lower than recommended doses.
authors.forename: Jorge Enrique
authors.initials: JE
authors.lastname: Machado-Alba
authors.forename: Andres
authors.initials: A
authors.lastname: Gaviria-Mendoza
authors.forename: Camila A
authors.initials: CA
authors.lastname: Vargas-Mosquera
authors.forename: Andrés Felipe
authors.initials: AF
authors.lastname: Gil-Restrepo
authors.forename: Luis C
authors.initials: LC
authors.lastname: Romero-Zapata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000191:economics* / Q000627:therapeutic use; D003105:Colombia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D016527:Drug Costs / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: chronic pain; drug prescriptions; inappropriate prescribing; opioid analgesics; pharmacoepidemiology