Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa.
J Arthroplasty. 2017 Dec;32(12):3578-3582.e1. doi: 10.1016/j.arth.2017.07.030. Epub 2017 Jul 25.
The United States is in the midst of an opioid epidemic. These medications continue to be used to manage pain associated with osteoarthritis, despite mounting evidence questioning the benefits. The rate at which opioids are prescribed for osteoarthritis is largely unknown. We sought to identify rates of opioid prescriptions for osteoarthritis and identify factors associated with higher rates of prescribing.
We queried the Humana, Inc. administrative claims database from 2007 to 2014. Patients with osteoarthritis were identified using International Classification of Diseases 9th Revision codes and classified as having hip, knee, or any joint osteoarthritis. Claims data were reviewed to identify opioid prescriptions associated with a diagnosis of osteoarthritis. Rates of prescribing were trended over time and stratified by sex, age, and geographic region.
From 2007 to 2014, 17.0% of patients with any joint osteoarthritis, 13.4% of patients with hip osteoarthritis, and 15.9% with knee osteoarthritis were prescribed an opioid for their condition. Yearly rates of prescription were fairly stable over this period. Patients in the South had the highest odds of opioid prescription, while those in the Northeast had the lowest. Patients ≤49 years old were more likely to receive a prescription than those ≥50 years old.
This study provides important epidemiologic data about the use of opioids for osteoarthritis. Despite increasing evidence calling proposed benefits into question and increasing awareness of risks of opioids, prescribing rates remained stable between 2007 and 2014. This provides important baseline data as we work to combat excessive and inappropriate opioid use within the United States.
美国正处于阿片类药物流行之中。尽管越来越多的证据对这些药物治疗骨关节炎相关疼痛的益处提出质疑，但它们仍在继续被用于治疗骨关节炎。目前尚不清楚阿片类药物用于治疗骨关节炎的比例。我们试图确定用于治疗骨关节炎的阿片类药物处方率，并确定与较高处方率相关的因素。
我们查询了 2007 年至 2014 年期间 Humana, Inc. 的管理索赔数据库。使用国际疾病分类第 9 版代码识别出骨关节炎患者，并将其分为髋、膝或任何关节骨关节炎。审查索赔数据以确定与骨关节炎诊断相关的阿片类药物处方。按时间趋势分析处方率，并按性别、年龄和地理位置进行分层。
2007 年至 2014 年间，17.0%的任何关节骨关节炎患者、13.4%的髋骨关节炎患者和 15.9%的膝骨关节炎患者因该疾病开具了阿片类药物处方。在此期间，每年的处方率相当稳定。南部地区的患者开具阿片类药物处方的可能性最高，而东北部地区的患者开具阿片类药物处方的可能性最低。≤49 岁的患者比≥50 岁的患者更有可能获得处方。
这项研究提供了关于阿片类药物治疗骨关节炎的重要流行病学数据。尽管越来越多的证据对拟议的益处提出质疑，并且对阿片类药物的风险的认识也在提高，但 2007 年至 2014 年间，处方率保持稳定。这为我们在美国努力打击过度和不适当的阿片类药物使用提供了重要的基线数据。
