Tapentadol and Oxycodone/Naloxone Prescribing Patterns in Primary Health Care in Catalonia, Spain: A Cross-Sectional Study

Abstract

Objective: To characterize the use of tapentadol and the combination oxycodone/naloxone in primary health care. Data on their use and possible misuse will allow the identification of risk factors and to design protocols to reduce and prevent avoidable harm to patients being treated for pain. Design: A descriptive, cross-sectional and multicenter study was performed. Setting: Fifty-three primary health care teams, which provides healthcare for 1,300,000 inhabitants. Patients: A total of 1840 patients had active prescriptions of tapentadol and 985 of oxycodone/naloxone. Methods: Demographic (age, sex) and clinical (glomerular filtration rate; active liver disease; dosing and duration of treatment), prescribed daily dose (according to age, sex, length of treatment), concomitant analgesic treatment and diagnosis. Patient information was obtained from medical records. Results: Most of the patients were women (>74.0% in both cases), and the average age was 69.3 years (women: 70.1±13.2; men: 66.7±13.9 years) in the case of tapentadol and 70.6 years (women: 64.0±13.6; men: 72.6±14.3 years) in the case of oxycodone/naloxone. Only 12.2% of patients taking tapentadol and 12.1% taking oxycodone/naloxone had a normal renal function. In both cases, 4.1% of patients had active liver disease. The average length of treatment was 246.4 days in oxycodone/naloxone and 199.0 days in tapentadol. It was recorded that 85.1% of patients in the case of tapentadol and 89.0% in the oxycodone/ naloxone had at least another drug prescribed for pain. About 42.2% of patients treated with tapentadol and 34.4% of patients treated with oxycodone/naloxone had associated neuralgia as a diagnosis. Conclusion:The pattern of use and profile of patients with tapentadol and oxycodone/ naloxone had more similarities than differences, and suggested that prescribing practice, and monitoring should be assessed regularly to ensure patient safety and effective management of pain.

Farmacogenética y respuesta analgésica: hacia una medicina personalizada con análisis de las diferencias por sexo

“…La relevancia de las posibles fluctuaciones en las concentraciones de este fármaco no reside tanto en el sexo puesto que no existen recomendaciones farmacogenéticas en la prescripción del mismo, si no más bien en la prevalencia de su prescripción. Así lo revela un estudio descriptivo en más de 1800 pacientes en Atención Primaria, se muestra que la prescripción junto con otros opioides es frecuente, puesto que sucedía entre el 85-89 % de los pacientes (78). En cualquier caso, en estudios propios observacionales retrospectivos, se ha detectado que las mujeres reciben una menor dosis media de opiodes mayores, incluyendo tapentadol (79).…”