Study Results from University of Zurich Update Understanding of Prescription Opioids (Increased risk of adverse events in non-cancer patients with chronic and high-dose opioid use-A health insurance claims analysis)

Insurance Daily News

2020 SEP 28 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Research findings on Opioids - Prescription Opioids are discussed in a new report. According to news reporting from Zurich, Switzerland, by NewsRx journalists, research stated, “Chronic and high dose opioid use may result in adverse events. We analyzed the risk associated with chronic and high dose opioid prescription in a Swiss population.”

The news correspondents obtained a quote from the research from the University of Zurich, “Using insurance claims data covering one-sixth of the Swiss population, we analyzed recurrent opioid prescriptions (2 opioid claims with at least 1 strong opioid claim) between 2006 and 2014. We calculated the cumulative dose in milligrams morphine equivalents (MED) and treatment duration. Excluded were single opioid claims, opioid use that was cancer treatment related, and opioid use in substitution programs. We assessed the association between the duration of opioid use, prescribed opioid dose, and benzodiazepine use with emergency department (ED) visits, urogenital and pulmonary infections, acute care hospitalization, and death at the end of the episode. In 63,642 recurrent opioid prescription episodes (acute 38%, subacute 7%, chronic 25.8%, very chronic (>360 days) episodes 29%) 18,336 ED visits, 30,209 infections, 19,375 hospitalizations, and 9,662 deaths occurred. The maximum daily MED dose was <20 mg in 15.8%, 20- <50 mg in 16.6%, 50- <100 mg in 21.6%, and 100 mg in 46%. Compared to acute episodes (<90 days), episode duration was an independent predictor of ED visits (chronic OR 1.09 (95% CI 1.03-1.15), very chronic (>360 days) OR 1.76 (1.67-1.86)) for adverse effects; infections (chronic OR 1.74 (1.66-1.82), very chronic 4.16 (3.95-4.37)), and hospitalization (chronic: OR 1.22 (1.16-1.29), very chronic OR 1.82 (1.73-1.93)). The risk of death decreased over time (very chronic OR 0.46 (0.43-0.50)). A dose dependent increased risk was observed for ED visits, hospitalization, and death (100mg daily MED OR 1.21 (1.13-1.29), OR 1.29 (1.21-1.38), and OR 1.67, 1.50-1.85, respectively). A concomitant use of benzodiazepines increased the odds for ED visits by 46% (OR 1.46, 1.41-1.52), infections by 44% (OR 1.44, 1.41-1.52), hospitalization by 12% (OR 1.12, 1.07-1.1), and death by 45% (OR 1.45, 1.37-1.53). The length of opioid use and higher prescribed morphine equivalent dose were independently associated with an increased risk for ED visits and hospitalizations.”

According to the news reporters, the research concluded: “The risk for infections, ED visits, hospitalizations, and death also increased with concomitant benzodiazepine use.”

For more information on this research see: Increased risk of adverse events in non-cancer patients with chronic and high-dose opioid use-A health insurance claims analysis. Plos One, 2020;15(9):e0238285. (Public Library of Science - www.plos.org; Plos One - www.plosone.org)

Our news journalists report that additional information may be obtained by contacting Ulrike Held, Dept. of Internal Medicine, Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland. Additional authors for this research include Jakob M. Burgstaller, Andri Signorell, Eva Blozik, Johann Steurer and Maria M. Wertli.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1371/journal.pone.0238285. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.