Duplicated tramadol use in chronic low back pain: A nationwide cross‐sectional study

Abstract

Tramadol is a weak opioid that is commonly used for chronic low back pain (LBP). Despite its effectiveness, duplicated use of tramadol, which may indicate abuse or dependence, may exacerbate potential adverse reactions. This population‐based, cross‐sectional study aimed to investigate the prevalence of duplication of tramadol and its associated factors among patients with LBP. From a Korean nationwide claims database, non‐hospitalized patients aged 40‐99 years with LBP without malignancy were prescribed tramadol during 2014‐2016. Duplication of tramadol was defined as overlapping of prescription days. Among them, we defined “extensive duplication (ED)” when days of tramadol duplication cover 10% or more of the days prescribed tramadol. Patient and healthcare utilization factors associated with ED were examined using a logistic regression model. The study population was 6 417 503 patients. Of these, 13.7% were ED users. The age‐ and sex‐standardized prevalence of using tramadol twice or more a year was 14.06 per 100 people in 2014, 13.74 per 100 people in 2015 and 13.52 per 100 people in 2016. ED occurred more in those in the group aged 70‐79 years (OR 1.12, 95% CI 1.11‐1.13) than 40‐49 years and in those with comorbidities, such as drug abuse (OR 2.99, 95% CI 2.05‐4.36) or depression (OR 1.75, 95% CI 1.72‐1.77). Based on the results of this study, a proper management system is needed to avoid tramadol duplication among older people and patients with drug abuse or depression.

Factors associated with the use of traditional doses of amitriptyline for chronic pain management: A cross-sectional study

“…Using the International Classification of Disease, Tenth Revision (ICD-10), we excluded those with 1 or more diagnoses of psychiatric disease (F00-F99) to limit the study population to patients who used amitriptyline for nonpsychiatric reasons. The diagnosis of chronic pain for the same claim with an amitriptyline prescription was assessed and classified as headache, [ 22 ] diabetic neuropathic pain (DNP), low back pain (LBP), [ 23 ] or other chronic pain. Chronic pain was defined using the ICD-10.…”

Class duplication prescriptions in patients taking fixed-dose combination antihypertensives

“…만성콩팥병 다 음으로, 심부전을 동반질환으로 가지고 있는 환자에서 CDP 비율이 높았다. 심부전 또한 다약제 사용이 많은 질환이며,32) 의료기관의 종류에 따라서는 의원을 방문한 환자들이 CDP 발생에 있어서 유의하게 낮은 관계가 있음을 보여주었는데, 이것은 기존의 연구들과 다른 결과였다 35,36). 국내는 약국 요 양급여비용 본인부담률 차등 적용에 관한 지침에 따라 282개 질환에 대하여서는 상급의료기관에서 처방시 환자의 본인부 담률이 의원에 비해 높아지는데, 악성이 아닌 고혈압(I10.0), 상세불명의 원발성 고혈압(I10.9)이 여기에 해당되어 합병증 을 동반한 고혈압이 아닌 경우 대부분의 고혈압 환자들은 의 원에서 처방을 받게 된다.…”