- Prescription of high-dose opioids in primary care settings is associated with an increased likelihood of benzodiazepine coprescription, depression, and more visits to emergency departments.
- These results are from a meta-analysis of studies from the United Kingdom, United States, and Australia.
Why this matters
- This study is the first meta-analysis to examine factors associated with high-dose opioid use by primary care patients.
- It highlights issues primary care clinicians should consider when formulating pain management strategies.
- A meta-analysis of 6 studies including 4,248,119 patients (aged ≥18 years) who had been prescribed opioids.
- Funding: National Institute for Health Research School for Primary Care.
- Total, 3.64% of patients were using high-dose opioids.
- Prescription of high-dose vs low-dose opioids was significantly associated (relative risk; 95% CI) with:
- Coprescription of benzodiazepines: 3.27 (1.32-8.13; I2=99.9%).
- Depression: 1.38 (1.27-1.51; I2=0%).
- Emergency department visits: 1.53 (1.46-1.61; I2=0%).
- Unemployment: 1.44 (1.27-1.63; I2=0%).
- Male sex: 1.21 (1.14-1.28; I2=78.6%).
- Number needed to harm: 15 (95% CI, 12-20).
- Included data from observational studies.
- Included only a small number of studies.
Coauthored with Vijay Rathod, PhD