Opioid Prescribing Trends in Patients With, Without Cancer
Opioid prescriptions saw a 1% annual increase in patients without cancer and a 1% decrease in patients with recent cancer.
Individuals with and without cancer may be affected in a similar manner by concerns surrounding opioids that have led to reductions in their prescribing, according to a study published in the Journal of Pain and Symptom Management.
Researchers conducted a cross-sectional analysis of data gathered between 2004 and 2013 for individuals ages 18 to 64 years with no history of cancer, a cancer diagnosis >5 years ago (remote), or a cancer diagnosis ≤5 years (recent), and who were eligible for Ontario Drugs Benefits Program.
Across the period analyzed, opioid prescription rates were 43% and 26% higher for patients with recent and remote cancer, respectively (P <.01 for both).
Opioid prescriptions saw a 1% annual increase in patients without cancer and a 1% decrease in patients with recent cancer. The largest annual increase in long-acting opioids was for long-acting oxycodone (8% to 15% in patients with cancer) up to 2011. Prescriptions for other long-acting opioids had annual increases ranging from 2% to 7% and immediate-release single agent prescriptions increased from 3% to 8%. Prescriptions for fentanyl decreased for patients with cancer, but they increased by 3% for those without cancer.
One important limitation is that drug data are only available for a portion of the population who might have been eligible for the study. This could limit the ability to generalize findings, as ineligible patients might not have similar levels of opioid use.
“Secular trends in opioid prescribing appear to influence cancer and noncancer patients similarly,” the researchers concluded. “Further research is required to assess their impact on symptom management as it will be important to ensure that policy changes meant to influence opioid prescribing in noncancer patients do not have unintended consequences for cancer patients,” they added.
Barbera L, Sutradhar R, Chu A, et al. Comparison of opioid prescribing among cancer and noncancer patients aged 18-64: Analysis using administrative data [published online March 14, 2018]. J Pain Symptom Manage. doi: 10.1016/j.jpainsymman.2018.03.010