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 in the inhibition of gastrointestinal (GI) motility, known as opioid-induced bowel dysfunction (OBD). OBD is typically treated prophylactically with laxatives and/or acid suppresants. Aims: The present study describes the prevalence of outpatient opioid dispensing, opioid patient demographics, and concomitant dispensing of opioid 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 as 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 lead to the cessation of opioid therapy. © 2008 Pulsus Group Inc. All rights reserved.