Inan Huang, an assistant professor of pharmacy administration and a research expert in rheumatology, discusses a pivotal study on opioid treatment trends for adults with systemic autoimmune and inflammatory rheumatic diseases. The conversation reveals how patients with conditions like rheumatoid arthritis face different challenges compared to the general population regarding opioid effectiveness and safety. Huang also addresses critical insights from the National Ambulatory Medical Care Survey, shedding light on disparities in prescribing practices and the urgent need for more research on long-term opioid use in these patients.
The study reveals significant disparities in opioid prescriptions, with over 20% of visits for SARD patients resulting in opioids compared to less than 10% for others.
Findings indicate older patients and those using glucocorticoids are more likely to be prescribed opioids, emphasizing complexity in pain management for SARDs.
Deep dives
Understanding Opioid Use in Autoimmune Diseases
The study examines opioid prescribing patterns among adults with systemic autoimmune and inflammatory rheumatic diseases (SARS) compared to those without these conditions. Chronic pain is prevalent in patients with these diseases, and the research highlights the need to understand how opioids are prescribed in this context. Opioids, traditionally effective for acute or cancer-related pain, show limited evidence of effectiveness for chronic pain, raising concerns due to their association with adverse events such as increased hospitalization and falls. This study aims to address these gaps by analyzing contemporary prescribing patterns to inform better pain management strategies.
Analysis of Prescription Data from National Surveys
Data from the National Ambulatory Medical Care Survey (NAMCS) formed the foundation for analyzing prescription patterns between SARS and non-SARS patients. With a focus on adult populations, the research identified significant differences in opioid prescriptions, showing that over 20% of visits involving SARS patients resulted in opioid prescriptions, compared to less than 10% for non-SARS patients. This substantial disparity underscores the importance of understanding the demographics, comorbidities, and medical care encounters involved in opioid prescribing. By leveraging a national dataset, the study provides insights into the current prescribing landscape and its implications for patient care.
The research utilized logistic regression analysis to identify key factors associated with opioid prescriptions among patients. Findings indicated that older patients (50 to 64 years) were more likely to receive opioids, while those with private insurance were less likely to be prescribed these medications compared to Medicare enrollees. Additionally, the use of oral glucocorticoids was positively associated with increased odds of receiving opioids, suggesting a potential link to disease activity. These results highlight the complexity of opioid prescribing in clinical practice and emphasize the need for ongoing analysis and patient-specific considerations.
In this episode, we explore the findings of a groundbreaking study analyzing opioid treatment trends for adults with and without systemic autoimmune and inflammatory rheumatic diseases (SARDs) from 2006 to 2019. The study, based on national data from the United States, sheds light on how individuals with conditions like rheumatoid arthritis, lupus, and ankylosing spondylitis are impacted by opioid use compared to the general population.
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