Prescription Opioid Registry Protocol in Integrated Health System

<li>The use of prescription opioids has increased dramatically in the past 2 decades, with associated increases in opioid misuse/abuse and opioid overdose.</li> <li>These are among the most commonly prescribed medications, with 259 million prescriptions written for opioid pain relievers in the U.S. in 2012.</li 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.<br>
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.<br>
Results found that in 2011:<br>
<li>18% of KPNC adult members filled at least 1 opioid prescription;</li><li>Among those patients, 25% used opioids long term and their average duration of use was more than 4 years;</li>
<li> Sedative/hypnotics were used by 76% of those long-term users;<br>
<li>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. <br>
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.</li>
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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.