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

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‐rec-ommended indications. In order to examine this concomitant risk prescription, we designed a de-scriptive, longitudinal, retrospective population‐based study. Patients aged ≥15 years with a con-tinued 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, benzodiaze-pines and antidepressants) and those who had received immediate‐release fentanyl (IRF) were se-lected. The study included 22,691 patients; 20,354 (89.7%) patients received concomitant risk pre-scriptions. 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.