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Predictors of Opioid Prescribing for Non-Malignant Low Back Pain in an Italian Primary Care Setting

This study explores which patient characteristics could affect the likelihood of starting low back pain (LBP) treatment with opioid analgesics vs. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in an Italian primary care setting. Through the computerized medical records of 65 General Practitioners,...

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Detalles Bibliográficos
Autores principales: Cammarota, Simona, Conti, Valeria, Corbi, Graziamaria, Di Gregorio, Luigi, Dolce, Pasquale, Fogliasecca, Marianna, Iannaccone, Teresa, Manzo, Valentina, Passaro, Vincenzo, Toraldo, Bernardo, Valente, Alfredo, Citarella, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397205/
https://www.ncbi.nlm.nih.gov/pubmed/34441993
http://dx.doi.org/10.3390/jcm10163699
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author Cammarota, Simona
Conti, Valeria
Corbi, Graziamaria
Di Gregorio, Luigi
Dolce, Pasquale
Fogliasecca, Marianna
Iannaccone, Teresa
Manzo, Valentina
Passaro, Vincenzo
Toraldo, Bernardo
Valente, Alfredo
Citarella, Anna
author_facet Cammarota, Simona
Conti, Valeria
Corbi, Graziamaria
Di Gregorio, Luigi
Dolce, Pasquale
Fogliasecca, Marianna
Iannaccone, Teresa
Manzo, Valentina
Passaro, Vincenzo
Toraldo, Bernardo
Valente, Alfredo
Citarella, Anna
author_sort Cammarota, Simona
collection PubMed
description This study explores which patient characteristics could affect the likelihood of starting low back pain (LBP) treatment with opioid analgesics vs. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in an Italian primary care setting. Through the computerized medical records of 65 General Practitioners, non-malignant LBP subjects who received the first pain intensity measurement and an NSAID or opioid prescription, during 2015–2016, were identified. Patients with an opioid prescription 1-year before the first pain intensity measurement were excluded. A multivariable logistic regression model was used to determine predictive factors of opioid prescribing. Results were reported as Odds Ratios (ORs) with a 95% confidence interval (CI), with p < 0.05 indicating statistical significance. A total of 505 individuals with LBP were included: of those, 72.7% received an NSAID prescription and 27.3% an opioid one (64% of subjects started with strong opioid). Compared to patients receiving an NSAID, those with opioid prescriptions were younger, reported the highest pain intensity (moderate pain OR = 2.42; 95% CI 1.48–3.96 and severe pain OR = 2.01; 95% CI 1.04–3.88) and were more likely to have asthma (OR 3.95; 95% CI 1.99–7.84). Despite clinical guidelines, a large proportion of LBP patients started with strong opioid therapy. Asthma, younger age and pain intensity were predictors of opioid prescribing when compared to NSAIDs for LBP treatment.
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spelling pubmed-83972052021-08-28 Predictors of Opioid Prescribing for Non-Malignant Low Back Pain in an Italian Primary Care Setting Cammarota, Simona Conti, Valeria Corbi, Graziamaria Di Gregorio, Luigi Dolce, Pasquale Fogliasecca, Marianna Iannaccone, Teresa Manzo, Valentina Passaro, Vincenzo Toraldo, Bernardo Valente, Alfredo Citarella, Anna J Clin Med Article This study explores which patient characteristics could affect the likelihood of starting low back pain (LBP) treatment with opioid analgesics vs. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in an Italian primary care setting. Through the computerized medical records of 65 General Practitioners, non-malignant LBP subjects who received the first pain intensity measurement and an NSAID or opioid prescription, during 2015–2016, were identified. Patients with an opioid prescription 1-year before the first pain intensity measurement were excluded. A multivariable logistic regression model was used to determine predictive factors of opioid prescribing. Results were reported as Odds Ratios (ORs) with a 95% confidence interval (CI), with p < 0.05 indicating statistical significance. A total of 505 individuals with LBP were included: of those, 72.7% received an NSAID prescription and 27.3% an opioid one (64% of subjects started with strong opioid). Compared to patients receiving an NSAID, those with opioid prescriptions were younger, reported the highest pain intensity (moderate pain OR = 2.42; 95% CI 1.48–3.96 and severe pain OR = 2.01; 95% CI 1.04–3.88) and were more likely to have asthma (OR 3.95; 95% CI 1.99–7.84). Despite clinical guidelines, a large proportion of LBP patients started with strong opioid therapy. Asthma, younger age and pain intensity were predictors of opioid prescribing when compared to NSAIDs for LBP treatment. MDPI 2021-08-20 /pmc/articles/PMC8397205/ /pubmed/34441993 http://dx.doi.org/10.3390/jcm10163699 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cammarota, Simona
Conti, Valeria
Corbi, Graziamaria
Di Gregorio, Luigi
Dolce, Pasquale
Fogliasecca, Marianna
Iannaccone, Teresa
Manzo, Valentina
Passaro, Vincenzo
Toraldo, Bernardo
Valente, Alfredo
Citarella, Anna
Predictors of Opioid Prescribing for Non-Malignant Low Back Pain in an Italian Primary Care Setting
title Predictors of Opioid Prescribing for Non-Malignant Low Back Pain in an Italian Primary Care Setting
title_full Predictors of Opioid Prescribing for Non-Malignant Low Back Pain in an Italian Primary Care Setting
title_fullStr Predictors of Opioid Prescribing for Non-Malignant Low Back Pain in an Italian Primary Care Setting
title_full_unstemmed Predictors of Opioid Prescribing for Non-Malignant Low Back Pain in an Italian Primary Care Setting
title_short Predictors of Opioid Prescribing for Non-Malignant Low Back Pain in an Italian Primary Care Setting
title_sort predictors of opioid prescribing for non-malignant low back pain in an italian primary care setting
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397205/
https://www.ncbi.nlm.nih.gov/pubmed/34441993
http://dx.doi.org/10.3390/jcm10163699
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