International Journal of Epidemiology | 2021
288What proportion of patients with chronic noncancer pain are prescribed an opioid medicine?
Abstract
\n \n \n Guidelines now discourage opioid analgesics for chronic non-cancer pain because the benefits frequently do not outweigh the harms. This review determined the proportion of patients with chronic non-cancer pain who are prescribed an opioid, the types prescribed, and factors associated with prescribing.\n \n \n \n Database searches were conducted from inception to 29th October 2018 without restrictions. We included observational studies of adults with chronic non-cancer pain measuring opioid prescribing. Opioids were categorised as weak (e.g. codeine) or strong (e.g. oxycodone). Risk of bias assessed study quality. Results were pooled using a random-effects model. Meta-regression investigated study-level factors associated with prescribing. The overall evidence quality was assessed using GRADE criteria.\n \n \n \n Of the 42 studies (5,059,098 participants) included, majority (n\u2009=\u200928) from the United States of America. Eleven studies were at low risk of bias. The pooled estimate of the proportion of patients with chronic non-cancer pain prescribed opioids was 30.7% (95%CI 28.7% to 32.7%, 42 studies, moderate-quality evidence). Strong opioids were more frequently prescribed than weak (18.4% (95%CI 16.0% to 21.0%, n\u2009=\u200915 studies, low-quality evidence), versus 8.5% (95%CI 7.2% to 9.9%, n\u2009=\u200915 studies, low-quality evidence)). Meta-regression determined opioid prescribing was associated with year of sampling (more prescribing in recent years) (p\u2009=\u20090.014) and not geographic region (p\u2009=\u20090.056).\n \n \n \n Opioid prescribing for patients with chronic non-cancer pain is common and has increased over time.\n \n \n \n Opioid prescribing for patients with chronic non-cancer pain and has increased over time. This review is the first systematic review to synthesized such data.\n