“Over the past decade, the federal government, state governments, medical societies, health systems and insurers have issued clinical guidelines and policies designed to reduce opioid prescribing,” the study investigators explained in their report. For this retrospective study, they had an aim of analyzing recent trends in the use of opioid vs nonopioid treatments in patients with CNCP or cancer diagnoses.
The study investigators analyzed data from the IBM MarketScan Research Databases to identify adults who had private insurance for at least 1 year between 2012 and 2019, and who had either a CNCP or cancer (excluding skin cancer) diagnosis. CNCP diagnoses could involve arthritis, headache, low back pain, and/or neuropathic pain. The investigators evaluated patterns in data related to receipt of opioid medication, nonopioid medication (of types concordant with clinical guidelines), or nonpharmacologic CNCP treatment.
Across the study population, the adjusted percentage of patients who received an opioid medication decreased from 86.0% to 78.7% in those with cancer (P <.01) and from 49.7% to 30.5% in those with CNCP (P <.01).
The adjusted percentage of patients with cancer receiving nonopioid medication increased during the study period from 74.4% to 78.8% (P <.01). For patients with CNCP, the adjusted percentage of those receiving nonopioid medications did not change (66.7% to 66.4%; P <.01). Use of nonpharmacologic therapy increased among the patients with CNCP during the study period (62.4% to 66.1%; P <.01).
Among those prescribed opioids, the receipt of 1 or more prescriptions with a strength corresponding to more than 90 morphine milligrams equivalent (MME) per day decreased in both patient groups. For those with a cancer diagnosis, this rate decreased from 26.2% to 7.6% (P <.01), and for those with a CNCP diagnosis, the rate decreased from 13.9% to 4.9% (P <.01).
Additional metrics showed significant decreases during the study for both patients with cancer and those with CNCP diagnoses, such as receipt of an opioid prescription for more than 7 days’ supply, the mean number of opioid prescriptions, and the mean MME per day for opioid prescriptions.
This study demonstrated that trends in opioid prescriptions for the patient populations in this study declined in the settings of cancer and CNCP diagnoses from 2012 to 2019. “Further investigation is needed to examine how these changes influence the management of pain among patients with CNCP and/or cancer,” they concluded.
Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Bandara S, Bicket MC, McGinty EE. Trends in opioid and non-opioid treatment for chronic non-cancer pain and cancer pain among privately insured adults in the United States, 2012–2019. PLoS One. 2022;17(8):e0272142. doi:10.1371/journal.pone.0272142