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.

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