Exploration of change in persistence patterns of opioid use among patients with non‐cancer and cancer pain over a 3‐year follow‐up period

Abstract

AbstractBackgroundLittle is known about the different patterns of persistent opioid use and whether the patterns of clinical opioid use remain the same throughout long‐term opioid therapy.AimThis study explored the different patterns of persistent opioid use and changes in these patterns over time in patients with non‐cancer and cancer pain.MethodsThis retrospective cross‐sectional study included patients with non‐cancer and cancer pain receiving opioid prescriptions during 2013–15 at outpatient tertiary hospital settings in Malaysia. A three‐dimensional (3D) persistence measure consisting of treatment intensity, frequency and distribution was used to define persistent opioid users as ‘wide’ (use opioids most of the days in a year), ‘intermediate’ (use opioids daily) or ‘strict’ (use opioids continuously to achieve a therapeutic concentration) users. The number of patients in each persistence group and changes in persistence patterns over time were recorded.ResultsMost persistent opioid users in the non‐cancer and cancer groups were defined as wide users (9.3% and 4.8%, respectively), followed by intermediate (3.1% and 0.5%, respectively) and strict (1.8% and 0.9%, respectively) users. Over the 3‐year study period, a change to a less stringent persistence definition was observed in the non‐cancer group, whereas no discernible pattern of change was observed in the cancer group.ConclusionChanges in the patterns of clinical opioid use over time were detected among persistent opioid users in both the non‐cancer and cancer groups using a 3D persistence measure. This measure, which is sensitive to changes in the clinical use of opioids over time, could affect future research and practices for better pain management involving opioids.