Characteristics of initial opioid dispensing
| Variable | Group; no (%) of participants | Difference in proportion,* % (95% CI) | |
|---|---|---|---|
| Long-term use n = 4172 | Short-term use n = 120 492 | ||
| Opioid dispensed at index date | |||
| Morphine | 1132 (27.1) | 39 051 (32.4) | −5.3 (−6.6 to −3.9) |
| Codeine | 347 (8.3) | 10 630 (8.8) | −0.5 (−1.3 to 0.0) |
| Hydromorphone | 1507 (36.1) | 47 729 (39.6) | −3.6 (−5.0 to −2.0) |
| Oxycodone | 797 (19.1) | 21 121 (17.5) | +1.6 (0.4 to 2.8) |
| Butorphanol | 1 (0.0) | 3 (0.0) | 0.0 (0.0 to 0.1) |
| Fentanyl | 264 (6.3) | 235 (0.2) | +6.1 (5.4 to 6.9) |
| Meperidine | 33 (0.8) | 1514 (1.3) | −0.5 (−0.7 to −0.1) |
| Pentazocine | 1 (0.0) | 16 (0.0) | 0.0 (0.0 to 0.1) |
| Concomitant products at index date | 90 (2.2) | 193 (0.2) | +2.0 (1.6 to 2.5) |
| Concomitant products during index dispensing | 141 (3.4) | 1252 (1.0) | +2.3 (1.8 to 3.0) |
| Mode of action | |||
| Short-acting | 3169 (76.0) | 118 885 (98.7) | −22.7 (−24.0 to −21.4) |
| Long-acting | 1003 (24.0) | 1607 (1.3) | +22.7 (21.4 to 24.0) |
| Initial dose, MME/d | |||
| < 30 | 2299 (55.1) | 49 381 (41.0) | +14.1 (12.6 to 15.7) |
| 30 to < 50 | 1071 (25.7) | 40 304 (33.4) | −7.8 (−9.1 to −6.4) |
| 50 to < 90 | 563 (13.5) | 26 526 (22.0) | −8.5 (−9.6 to −7.4) |
| ≥ 90 | 239 (5.7) | 4281 (3.6) | +2.2 (1.5 to 2.9) |
| Initial supply, d | |||
| < 15 | 2456 (58.9) | 112 104 (93.0) | −34.2 (−35.7 to −32.7) |
| 15 to 29 | 584 (14.0) | 5065 (4.2) | +9.8 (8.8 to 10.9) |
| ≥ 30 | 1132 (27.1) | 3323 (2.8) | +24.4 (23.0 to 25.8) |
| Prescriber’s specialty | |||
| Family medicine | 3567 (85.5) | 82 913 (68.8) | +16.7 (15.6 to 17.8) |
| Surgery | 177 (4.2) | 23 742 (19.7) | −15.5 (−16.1 to −14.8) |
| Gynecology | 2 (0.1) | 2014 (1.7) | −1.6 (−1.7 to −1.5) |
| Emergency medicine | 47 (1.1) | 2927 (2.4) | −1.3 (−1.6 to −0.9) |
| Urology | 6 (0.1) | 1802 (1.5) | −1.4 (−1.5 to −1.2) |
| Dentistry | 1 (0.0) | 1573 (1.3) | −1.3 (−1.4 to −1.2) |
| Other† | 352 (8.4) | 4886 (4.1) | +4.4 (3.6 to 5.3) |
| Unknown | 20 (0.5) | 635 (0.5) | 0.0 (0.0 to 0.2) |
Note: CI = confidence interval, MME = morphine milligram equivalent.
↵* Positive difference values indicate that value for patients with long-term use was greater than value for patients with short-term use; negative difference values indicate that value for patients with long-term use was less than value for patients with short-term use.
↵† Other specialties included immunology, pathology, anesthesiology, cardiology, dermatology, gastroenterology, hematology, pneumonology, internal medicine, physiatry, neurology, ophthalmology, otolaryngology, psychiatry, nuclear medicine, nephrology, endocrinology, rheumatology and geriatrics.