Trends in the Prescription of Strong Opioids for Chronic Non-Cancer Pain in Primary Care in Catalonia: Opicat-Padris-Project

Abstract

In chronic non-cancer pain (CNCP), evidence of the effectiveness of strong opioids (SO) is very limited. Despite this, their use is increasingly common. To examine SO prescriptions, we designed a descriptive, longitudinal, retrospective population-based study, including patients aged ≥15 years prescribed SO for ≥3 months continuously in 2013–2017 for CNCP in primary care in Catalonia. Of the 22,691 patients included, 17,509 (77.2%) were women, 10,585 (46.6%) were aged >80 years, and most had incomes of <€18,000 per year. The most common diagnoses were musculoskeletal diseases and psychiatric disorders. There was a predominance of transdermal fentanyl in the defined daily dose (DDD) per thousand inhabitants/day, with the greatest increase for tapentadol (312% increase). There was an increase of 66.89% in total DDD per thousand inhabitants/day for SO between 2013 (0.737) and 2017 (1.230). The mean daily oral morphine equivalent dose/day dispensed for all drugs was 83.09 mg. Transdermal fentanyl and immediate transmucosal release were the largest cost components. In conclusion, there was a sustained increase in the prescription of SO for CNCP, at high doses, and in mainly elderly patients, predominantly low-income women. The new SO are displacing other drugs.

Thermal imaging of local skin temperature as part of quality and safety assessment of injectable drugs

“…Some physicians have tried to reduce opioids and other intravenous injections after witnessing this unintentionally. [ 17 , 18 ]. However, intramuscular, subcutaneous, and other drug injections do not prevent general or local complications [ [19] , [20] , [21] ].…”

Tapentadol for the management of cancer pain in adults: an update

“…Tapentadol has been marketed in Australia, Europe, and the USA for at least 12 years 1▪▪ and it is being increasingly used 2,3. Tapentadol was synthetized using rational drug-design to create a molecule with µ-opioid receptor (MOR) agonism and noradrenalin reuptake inhibition (NRI) (Fig.…”

Opioid prescription patterns in the province of Las Palmas, Canary Islands, Spain (2016–2020): differences between urban and rural areas

“…However, other studies suggest that women are more likely to be prescribed opioids in CNCP. Perelló-Bratescu et al (2022) analyzed the trends in the prescription of strong opioids for this pathology in primary care in Catalonia, Spain, using a descriptive, longitudinal, retrospective population-based study from 2013 to 2017. This study showed that there was a sustained increase in the prescription of strong opioids at high doses, and in mainly elderly patients, predominantly low-income women.…”