Cohort profile: development and characteristics of a retrospective cohort of individuals dispensed prescription opioids for non-cancer pain in British Columbia, Canada
Purpose Prescription opioids (POs) are widely prescribed for chronic non-cancer pain but are associated with several risks and limited long-term benefit. Large, linked data sources are needed to monitor their harmful effects. We developed and characterised a retrospective cohort of people dispensed...
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BMJ Publishing Group
2021-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/4/e043586.full |
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| author | Tara Gomes James Wilton Robert F Balshaw Stanley Wong Amanda Yu Maria Alvarez Michael Otterstatter Naveed Zafar Janjua Mei Chong Younathan Abdia Roy Purssell Aaron MacInnes Richard C Dart Jane A Buxton |
| author_facet | Tara Gomes James Wilton Robert F Balshaw Stanley Wong Amanda Yu Maria Alvarez Michael Otterstatter Naveed Zafar Janjua Mei Chong Younathan Abdia Roy Purssell Aaron MacInnes Richard C Dart Jane A Buxton |
| author_sort | Tara Gomes |
| collection | DOAJ |
| description | Purpose Prescription opioids (POs) are widely prescribed for chronic non-cancer pain but are associated with several risks and limited long-term benefit. Large, linked data sources are needed to monitor their harmful effects. We developed and characterised a retrospective cohort of people dispensed POs.Participants We used a large linked administrative database to create the Opioid Prescribing Evaluation and Research Activities cohort of individuals dispensed POs for non-cancer pain in British Columbia (BC), Canada (1996–2015). We created definitions to categorise episodes of PO use based on a review of the literature (acute, episodic, chronic), developed an algorithm for inferring clinical indication and assessed patterns of PO use across a range of characteristics.Findings to date The current cohort includes 1.1 million individuals and 3.4 million PO episodes (estimated to capture 40%–50% of PO use in BC). The majority of episodes were acute (81%), with most prescribed for dental or surgical pain. Chronic use made up 3% of episodes but 88% of morphine equivalents (MEQ). Across the acute to episodic to chronic episode gradient, there was an increasing prevalence of higher potency POs (hydromorphone, oxycodone, fentanyl, morphine), long-acting formulations and chronic pain related indications (eg, back, neck, joint pain). Average daily dose (MEQ) was similar for acute/episodic but higher for chronic episodes. Approximately 7% of the cohort had a chronic episode and chronic pain was the characteristic most strongly associated with chronic PO use. Individuals initiating a chronic episode were also more likely to have higher social/material deprivation and previous experience with a mental health condition or a problem related to alcohol or opioid use. Overall, these findings suggest our episode definitions have face validity and also provide insight into characteristics of people initiating chronic PO therapy.Future plans The cohort will be refreshed every 2 years. Future analyses will explore the association between POs and adverse outcomes. |
| format | Article |
| id | doaj-art-c3a127660c9344ff8cf3ad07def96cec |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c3a127660c9344ff8cf3ad07def96cec2024-11-21T20:10:09ZengBMJ Publishing GroupBMJ Open2044-60552021-04-0111410.1136/bmjopen-2020-043586Cohort profile: development and characteristics of a retrospective cohort of individuals dispensed prescription opioids for non-cancer pain in British Columbia, CanadaTara Gomes0James Wilton1Robert F Balshaw2Stanley Wong3Amanda Yu4Maria Alvarez5Michael Otterstatter6Naveed Zafar Janjua7Mei Chong8Younathan Abdia9Roy Purssell10Aaron MacInnes11Richard C Dart12Jane A Buxton13ICES, Toronto, Ontario, Canada2UNIVERSITY COLLEGE OF LONDON, Arthritis Research United Kingdom Centre for Adolescent Rheumatology at UCLH, UCL and Great Ormond Street Institute of Child Health, LONDON, United Kingdom5 University of Manitoba, Winnipeg, Manitoba, CanadaBC Centre for Disease Control, Vancouver, British Columbia, CanadabiostatisticianepidemiologistBC Centre for Disease Control, Vancouver, British Columbia, CanadaSchool of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, CanadaBC Centre for Disease Control, Vancouver, British Columbia, Canadabiostatisticianprofessorpain management specialist and anaesthesiologistRocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA2 Harm Reduction, BC Centre for Disease Control, Vancouver, British Columbia, CanadaPurpose Prescription opioids (POs) are widely prescribed for chronic non-cancer pain but are associated with several risks and limited long-term benefit. Large, linked data sources are needed to monitor their harmful effects. We developed and characterised a retrospective cohort of people dispensed POs.Participants We used a large linked administrative database to create the Opioid Prescribing Evaluation and Research Activities cohort of individuals dispensed POs for non-cancer pain in British Columbia (BC), Canada (1996–2015). We created definitions to categorise episodes of PO use based on a review of the literature (acute, episodic, chronic), developed an algorithm for inferring clinical indication and assessed patterns of PO use across a range of characteristics.Findings to date The current cohort includes 1.1 million individuals and 3.4 million PO episodes (estimated to capture 40%–50% of PO use in BC). The majority of episodes were acute (81%), with most prescribed for dental or surgical pain. Chronic use made up 3% of episodes but 88% of morphine equivalents (MEQ). Across the acute to episodic to chronic episode gradient, there was an increasing prevalence of higher potency POs (hydromorphone, oxycodone, fentanyl, morphine), long-acting formulations and chronic pain related indications (eg, back, neck, joint pain). Average daily dose (MEQ) was similar for acute/episodic but higher for chronic episodes. Approximately 7% of the cohort had a chronic episode and chronic pain was the characteristic most strongly associated with chronic PO use. Individuals initiating a chronic episode were also more likely to have higher social/material deprivation and previous experience with a mental health condition or a problem related to alcohol or opioid use. Overall, these findings suggest our episode definitions have face validity and also provide insight into characteristics of people initiating chronic PO therapy.Future plans The cohort will be refreshed every 2 years. Future analyses will explore the association between POs and adverse outcomes.https://bmjopen.bmj.com/content/11/4/e043586.full |
| spellingShingle | Tara Gomes James Wilton Robert F Balshaw Stanley Wong Amanda Yu Maria Alvarez Michael Otterstatter Naveed Zafar Janjua Mei Chong Younathan Abdia Roy Purssell Aaron MacInnes Richard C Dart Jane A Buxton Cohort profile: development and characteristics of a retrospective cohort of individuals dispensed prescription opioids for non-cancer pain in British Columbia, Canada BMJ Open |
| title | Cohort profile: development and characteristics of a retrospective cohort of individuals dispensed prescription opioids for non-cancer pain in British Columbia, Canada |
| title_full | Cohort profile: development and characteristics of a retrospective cohort of individuals dispensed prescription opioids for non-cancer pain in British Columbia, Canada |
| title_fullStr | Cohort profile: development and characteristics of a retrospective cohort of individuals dispensed prescription opioids for non-cancer pain in British Columbia, Canada |
| title_full_unstemmed | Cohort profile: development and characteristics of a retrospective cohort of individuals dispensed prescription opioids for non-cancer pain in British Columbia, Canada |
| title_short | Cohort profile: development and characteristics of a retrospective cohort of individuals dispensed prescription opioids for non-cancer pain in British Columbia, Canada |
| title_sort | cohort profile development and characteristics of a retrospective cohort of individuals dispensed prescription opioids for non cancer pain in british columbia canada |
| url | https://bmjopen.bmj.com/content/11/4/e043586.full |
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