Prescription Opioid Registry Protocol in Integrated Health System

  • The use of prescription opioids has increased dramatically in the past 2 decades, with associated increases in opioid misuse/abuse and opioid overdose.
  • These are among the most commonly prescribed medications, with 259 million prescriptions written for opioid pain relievers in the U.S. in 2012.
  • This study, part of CTN-0061-Ot, aimed to establish a prescription opioid registry protocol in a large health system, Kaiser Permanente Northern California (KPNC), and to describe algorithms to characterize individuals using prescription opioids, opioid use episodes, and concurrent use of sedative/hypnotics.

    Using KPNC electronic health record data, the investigators selected patients using prescription opioids in 2011. Opioid and sedative/hypnotic fills, and physical and psychiatric comorbidity diagnoses were extracted for years 2008 to 2014. Algorithms were developed to identify each patient’s daily opioid and sedative/hypnotic use, and morphine daily-dose equivalent and logistic regression was used to predict characteristics associated with becoming a long-term opioid user.

    Results found that in 2011:

  • 18% of KPNC adult members filled at least 1 opioid prescription;
  • Among those patients, 25% used opioids long term and their average duration of use was more than 4 years;
  • Sedative/hypnotics were used by 76% of those long-term users;
  • Being older, white, living in a more deprived neighborhood, having a chronic pain diagnosis, and use of sedative/hypnotics were predictors of initiating long-term opioid use.

    Conclusions: This study established a population-based opioid registry that is flexible and can be used to address important questions of prescription opioid use. It will be used in future studies to answer a broad range of other critical public health issues relating to prescription opioid use.
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    Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.

    Articles were written based on the following published research:

    Ray GT, et al. Prescription Opioid Registry Protocol in an Integrated Health System. American Journal of Managed Care2017;23(5):e146-e155.