Prescribing Pattern of Analgesics in Colombia. Are there Differences between Capital Cities and Municipalities? A Cross-Sectional Study

BACKGROUND: Analgesics provide multiple clinical benefits but they are not without risks. OBJECTIVE: The aim of this study was to compare the outpatient prescribing pattern of analgesics between cities and municipalities in Colombia and to identify the variables associated with prescribing opioid analgesics. METHODS: This was a cross-sectional study that identified the prescription of analgesics for outpatient use from a population database of 8.5 million Colombians. A descriptive, bivariate, and multivariate analysis was performed. RESULTS: A total of 573,248 patients were identified who had received prescriptions for an analgesic. Mean age was 46.5 ± 23.6 years and 65.7% were females. The most commonly prescribed analgesics were non-opioid analgesics, antispasmodics, and opioid analgesics. The average milligram equivalent of morphine was higher in capital cities than in municipalities. Age ≥ 65 years (odds ratio [OR] 2.60, 95% confidence interval [CI] 2.54–2.67), male sex (OR 1.09, 95% CI 1.07–1.11), dispensing in cities (OR 2.25, 95% CI 2.20–2.30) and experiencing chronic pain (OR 13.25, 95% CI 10.89–16.14) were associated with an increased risk of receiving an opioid analgesic. CONCLUSIONS: Differences were found in the prescription of analgesics between capital cities and municipalities. The use of opioids does not appear to be in line with the recommendations for clinical practice, and they were mainly prescribed for elderly males with chronic non-oncological pain and for residents of capital cities.