Physician Prescribing Patterns and Risk of Future Long-Term Opioid Use Among Patients With Rheumatoid Arthritis: A Prospective Observational Cohort Studys

Objective To identify the extent to which opioid prescribing rates for patients with rheumatoid arthritis (RA) vary in theUSand to determine the implications of baseline opioid prescribing rates on the probability of future long-term opioid use. Methods We identified patients withRAfrom physicians who contributed >= 10 patients within the first 12 months of participation in the CorronaRARegistry. The baseline opioid prescribing rate was calculated by dividing the number of patients withRAreporting opioid use during the first 12 months by the number of patients withRAproviding data that year. To estimate odds ratios (ORs) for long-term opioid use, we used generalized linear mixed models. Results During the follow-up period, long-term opioid use was reported by 7.0% (163 of 2,322) of patients of physicians with a very low rate of opioid prescribing (referent) compared to 6.8% (153 of 2,254) of patients of physicians with a low prescribing rate, 12.5% (294 of 2,352) of patients of physicians with a moderate prescribing rate, and 12.7% (307 of 2,409) of patients of physicians with a high prescribing rate. TheORfor long-term opioid use after the baseline period was 1.16 (95% confidence interval [95%CI] 0.79-1.70) for patients of low-intensity prescribing physicians, 1.89 (95%CI1.27-2.82) for patients of moderate-intensity prescribing physicians, and 2.01 (95%CI1.43-2.83) for patients of high-intensity prescribing physicians, compared to very low-intensity prescribing physicians. Conclusion Rates of opioid prescriptions vary widely. Our findings indicate that baseline opioid prescribing rates are a strong predictor of whether a patient will become a long-term opioid user in the future, after controlling for patient characteristics.