Nonopioid ache prescriptions elevated after 2016 CDC guideline

After the Facilities for Illness Management and Prevention launched a tenet for prescribing opioids to sufferers experiencing power ache in 2016, the prescribing charge of non-opioid ache remedy elevated annually above and past what could be anticipated based mostly on the preexisting tendencies, a brand new research finds.

The 2016 guideline aimed to assist U.S. clinicians deal with grownup sufferers for power ache whereas weighing the advantages and dangers of prescribing opioids, as extra People died of opioid-related overdose. Utilizing insurance coverage claims information from over 15 million sufferers, a staff of researchers from Michigan Drugs and the CDC analyzed the prescribing charges of nonopioid ache medicines, akin to acetaminophen and nonsteroidal anti-inflammatory medicine (NSAIDs).

They discovered that the odds of prescribing a nonopioid ache remedy in 2016 have been 3% increased than anticipated from pre-guideline estimates for a similar 12 months. That quantity elevated to eight% in 2017 and 9.7% in 2018. The outcomes are printed in JAMA Community Open.

“These findings recommend that clinicians have been prescribing nonopioid ache medicines extra ceaselessly because the 2016 guideline was launched, and which will imply that they’ve thought of opioid remedy provided that its anticipated advantages exceeded the anticipated dangers to the affected person,” stated Jason Goldstick, Ph.D., lead creator of the research and a analysis affiliate professor of emergency drugs at College of Michigan Medical Faculty.

“Although many traits – akin to ache depth and effectiveness of ache administration – are usually not out there in these information, these outcomes could signify a rise in guideline-concordant ache therapy.”

The rise in nonopioid ache remedy prescribing coincided with a major drop in opioid prescribing over the identical interval, according to different analysis displaying reductions in opioid prescribing following the 2016 guideline launch. Will increase in nonopioid ache remedy prescribing have been constant throughout a number of affected person subpopulations, together with these with latest opioid publicity, in addition to these with nervousness or temper issues.

“The 2016 guideline inspired warning in prescribing opioids, and it was doable that it might have lowered using ache remedies general,” stated Amy Bohnert, Ph.D., M.H.S., senior creator of the paper and affiliate professor of psychiatry at U-M Medical Faculty. “Our evaluation supplies an encouraging signal that sufferers have been extra usually provided different remedies for ache than earlier than the rule of thumb, moderately than solely being provided opioids much less usually.”

Researchers say the modifications in prescribing could have additionally led to a shift towards using some nonpharmacologic remedies, together with bodily remedy and cognitive behavioral remedy. They observe further analysis on modifications in nonpharmacologic ache remedies, in addition to undertreatment of ache and affected person ache outcomes, are wanted to realize a fuller understanding of modifications to the ache administration panorama following the 2016 guideline launch.

“Multimodal and multidisciplinary approaches to ache administration that deal with the organic, psychological and social traits of every particular person are a vital a part of a complete therapy protocol,” researchers wrote. “Additional evaluation may help establish the avenues by way of which ache reduction could be optimized.”

Further authors embrace, Matthew G Myers, M.P.H., of Michigan Drugs, and Gery P. Man, Ph.D., M.P.H., Jan L. Losby, Ph.D., M.S.W., and Grant T. Baldwin, Ph.D., M.P.H., all the CDC

This work was funded partly by grant 19IPA1906094 (Dr Goldstick), U01CE002780 (Dr Bohnert), and R49CE003085 from the Facilities for Illness Management and Prevention.

Paper Cited: “Patterns in Nonopioid Ache Treatment Prescribing After the Launch of the 2016 Guideline for Prescribing Opioids for Persistent Ache,” JAMA Community Open. DOI: 10.1001/jamanetworkopen.2022.16475