British journal of clinical pharmacology · 2025
The persistence of chronic opioid use in patients with inflammatory bowel disease-A nationwide cohort study.
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Nørgård Bente Mertz, Thorarinsson Caroline Theilgaard, Nielsen Jan, Andersen Mette Louise, Kjeldsen Jens, Knudsen Torben, Dalal Rahul S
Аннотация
AIMS: Pain is common in patients with Crohn's disease (CD) and ulcerative colitis (UC), and a substantial proportion develop chronic opioid use (COU). We examined the persistence of COU over time and identified factors predicting persistent use.
METHODS: This nationwide Danish cohort study included patients with an initial period of COU (definition: ≥3 opioid prescriptions within 12 months with at least 30 days between prescriptions). We examined persistent COU for 2 years thereafter. Predictors for persistent COU were examined in multivariable logistic regression analyses.
RESULTS: Among 6208 patients with COU, 49.6% had persistent COU in the first follow-up year: 30.4% with only weak opioids, 11.7% with weak/strong opioids and 7.5% with only strong opioids. In the second follow-up year, two-thirds of those with persistent COU remained chronic users. Among 2553 patients with CD, key predictors of persistent COU in the first year of follow-up were age ≥70 years at disease onset (adjusted odds ratio [aOR] = 1.73, 95% CI: 1.22-2.45) and antidepressant use (aOR = 1.44, 95% CI: 1.18-1.75). Among the 3655 patients with UC, predictors included high comorbidity (aOR = 1.45, 95% CI: 1.05-2.00), age ≥70 years (aOR = 1.41, 95% CI: 1.09-1.82) and anxiolytic use (aOR = 1.38, 95% CI: 1.12-1.71).
CONCLUSIONS: After an initial period of COU, half of all patients had persistent COU after 1 year, and among these two-thirds still had COU after an additional year. The main predictors of persistent COU were factors related to vulnerability (advanced age and mental health conditions).
METHODS: This nationwide Danish cohort study included patients with an initial period of COU (definition: ≥3 opioid prescriptions within 12 months with at least 30 days between prescriptions). We examined persistent COU for 2 years thereafter. Predictors for persistent COU were examined in multivariable logistic regression analyses.
RESULTS: Among 6208 patients with COU, 49.6% had persistent COU in the first follow-up year: 30.4% with only weak opioids, 11.7% with weak/strong opioids and 7.5% with only strong opioids. In the second follow-up year, two-thirds of those with persistent COU remained chronic users. Among 2553 patients with CD, key predictors of persistent COU in the first year of follow-up were age ≥70 years at disease onset (adjusted odds ratio [aOR] = 1.73, 95% CI: 1.22-2.45) and antidepressant use (aOR = 1.44, 95% CI: 1.18-1.75). Among the 3655 patients with UC, predictors included high comorbidity (aOR = 1.45, 95% CI: 1.05-2.00), age ≥70 years (aOR = 1.41, 95% CI: 1.09-1.82) and anxiolytic use (aOR = 1.38, 95% CI: 1.12-1.71).
CONCLUSIONS: After an initial period of COU, half of all patients had persistent COU after 1 year, and among these two-thirds still had COU after an additional year. The main predictors of persistent COU were factors related to vulnerability (advanced age and mental health conditions).