Explosive Increase in Tramadol Use in Korea 2003–2013: Analysis of Patient Trends Based on the Korea National Health Insurance Database

Abstract

ABSTRACT Our study assessed the trends and patterns of tramadol prescriptions and possible correlations of a person being prescribed tramadol using the Korean National Health Insurance Service Sample Cohort from 2003 to 2013. The study population consisted of patients who were prescribed tramadol, opioids, or nonsteroidal anti-inflammatory drugs (NSAIDs) in an outpatient setting. From 2003 to 2013, the number of tramadol users increased from 2,476 (19.9% of the study population in 2003) to 124,592 (33.3% of the 2013 study population). The absolute change in the proportion of study patients prescribed tramadol (%) was +13.4%, a relative change (%) of +67.3%. In contrast, absolute changes in the number of opioid and NSAID users were −4.78% and −8.65%, respectively, which were relative changes of −73.5% and −11.8%, respectively. Of the studied pain types, arthritis and back pain were the most prominent diagnoses in tramadol users. Notable correlations for tramadol prescriptions, when compared with NSAIDs, were rural area (adjusted odds ratio (aOR): 1.64; 95% CI 1.61–1.66), co-prescription of a benzodiazepine (aOR 2.01; 95% CI 1.97–2.05), and tertiary hospital (aOR: 3.08, 95% CI 3.00–3.17).