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Doctor shopping among chronic noncancer pain patients treated with opioids in the province of Quebec (Canada): incidence, risk factors, and association with the occurrence of opioid overdoses

INTRODUCTION: Prescription opioids continue to be involved in the opioid crisis, and a better understanding of factors associated with problematic opioid use is needed. OBJECTIVES: The aim of this study was to assess the incidence of opioid doctor shopping, a proxy for problematic opioid use, to ide...

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Autores principales: Kaboré, Jean-Luc, Pagé, M. Gabrielle, Dassieu, Lise, Tremblay, Éric, Benigeri, Mike, Roy, Denis A., Lacasse, Anaïs, Choinière, Manon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853613/
https://www.ncbi.nlm.nih.gov/pubmed/35187376
http://dx.doi.org/10.1097/PR9.0000000000000955
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author Kaboré, Jean-Luc
Pagé, M. Gabrielle
Dassieu, Lise
Tremblay, Éric
Benigeri, Mike
Roy, Denis A.
Lacasse, Anaïs
Choinière, Manon
author_facet Kaboré, Jean-Luc
Pagé, M. Gabrielle
Dassieu, Lise
Tremblay, Éric
Benigeri, Mike
Roy, Denis A.
Lacasse, Anaïs
Choinière, Manon
author_sort Kaboré, Jean-Luc
collection PubMed
description INTRODUCTION: Prescription opioids continue to be involved in the opioid crisis, and a better understanding of factors associated with problematic opioid use is needed. OBJECTIVES: The aim of this study was to assess the incidence of opioid doctor shopping, a proxy for problematic opioid use, to identify associated risk factors, and to assess its association with the occurrence of opioid overdoses. METHODS: This was a retrospective cohort study of people living with chronic noncancer pain (CNCP) and treated with opioids for at least 6 months between 2006 and 2017 in the province of Quebec (Canada). Data were drawn from the Quebec health administrative databases. Doctor shopping was defined as overlapping prescriptions written by ≥ 2 prescribers and filled in ≥3 pharmacies. RESULTS: A total of 8,398 persons with CNCP were included. The median age was 68.0 (Q1: 54; Q3: 82) years, and 37.1% were male. The 1-year incidence of opioid doctor shopping was 7.8%, 95% confidence interval (CI): 7.2–8.5. Doctor shopping was associated with younger age (hazard ratio [HR] 18–44 vs ≥65 years: 2.22, 95% CI: 1.77–2.79; HR 45–64 vs ≥65 years: 1.34, 95% CI: 1.11–1.63), male sex (HR = 1.20, 95% CI: 1.01–1.43), history of substance use disorder (HR = 1.32, 95% CI: 1.01–1.72), and anxiety (HR = 1.41, 95% CI: 1.13–1.77). People who exhibited doctor shopping were 5 times more likely to experience opioid overdoses (HR = 5.25, 95% CI: 1.44–19.13). CONCLUSION: Opioid doctor shopping is a marginal phenomenon among people with CNCP, but which is associated with the occurrence of opioid overdoses. Better monitoring of persons at high risk to develop doctor shopping could help prevent opioid overdoses.
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spelling pubmed-88536132022-02-18 Doctor shopping among chronic noncancer pain patients treated with opioids in the province of Quebec (Canada): incidence, risk factors, and association with the occurrence of opioid overdoses Kaboré, Jean-Luc Pagé, M. Gabrielle Dassieu, Lise Tremblay, Éric Benigeri, Mike Roy, Denis A. Lacasse, Anaïs Choinière, Manon Pain Rep Pharmacology INTRODUCTION: Prescription opioids continue to be involved in the opioid crisis, and a better understanding of factors associated with problematic opioid use is needed. OBJECTIVES: The aim of this study was to assess the incidence of opioid doctor shopping, a proxy for problematic opioid use, to identify associated risk factors, and to assess its association with the occurrence of opioid overdoses. METHODS: This was a retrospective cohort study of people living with chronic noncancer pain (CNCP) and treated with opioids for at least 6 months between 2006 and 2017 in the province of Quebec (Canada). Data were drawn from the Quebec health administrative databases. Doctor shopping was defined as overlapping prescriptions written by ≥ 2 prescribers and filled in ≥3 pharmacies. RESULTS: A total of 8,398 persons with CNCP were included. The median age was 68.0 (Q1: 54; Q3: 82) years, and 37.1% were male. The 1-year incidence of opioid doctor shopping was 7.8%, 95% confidence interval (CI): 7.2–8.5. Doctor shopping was associated with younger age (hazard ratio [HR] 18–44 vs ≥65 years: 2.22, 95% CI: 1.77–2.79; HR 45–64 vs ≥65 years: 1.34, 95% CI: 1.11–1.63), male sex (HR = 1.20, 95% CI: 1.01–1.43), history of substance use disorder (HR = 1.32, 95% CI: 1.01–1.72), and anxiety (HR = 1.41, 95% CI: 1.13–1.77). People who exhibited doctor shopping were 5 times more likely to experience opioid overdoses (HR = 5.25, 95% CI: 1.44–19.13). CONCLUSION: Opioid doctor shopping is a marginal phenomenon among people with CNCP, but which is associated with the occurrence of opioid overdoses. Better monitoring of persons at high risk to develop doctor shopping could help prevent opioid overdoses. Wolters Kluwer 2021-09-16 /pmc/articles/PMC8853613/ /pubmed/35187376 http://dx.doi.org/10.1097/PR9.0000000000000955 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Pharmacology
Kaboré, Jean-Luc
Pagé, M. Gabrielle
Dassieu, Lise
Tremblay, Éric
Benigeri, Mike
Roy, Denis A.
Lacasse, Anaïs
Choinière, Manon
Doctor shopping among chronic noncancer pain patients treated with opioids in the province of Quebec (Canada): incidence, risk factors, and association with the occurrence of opioid overdoses
title Doctor shopping among chronic noncancer pain patients treated with opioids in the province of Quebec (Canada): incidence, risk factors, and association with the occurrence of opioid overdoses
title_full Doctor shopping among chronic noncancer pain patients treated with opioids in the province of Quebec (Canada): incidence, risk factors, and association with the occurrence of opioid overdoses
title_fullStr Doctor shopping among chronic noncancer pain patients treated with opioids in the province of Quebec (Canada): incidence, risk factors, and association with the occurrence of opioid overdoses
title_full_unstemmed Doctor shopping among chronic noncancer pain patients treated with opioids in the province of Quebec (Canada): incidence, risk factors, and association with the occurrence of opioid overdoses
title_short Doctor shopping among chronic noncancer pain patients treated with opioids in the province of Quebec (Canada): incidence, risk factors, and association with the occurrence of opioid overdoses
title_sort doctor shopping among chronic noncancer pain patients treated with opioids in the province of quebec (canada): incidence, risk factors, and association with the occurrence of opioid overdoses
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853613/
https://www.ncbi.nlm.nih.gov/pubmed/35187376
http://dx.doi.org/10.1097/PR9.0000000000000955
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