Men, age, yr |
18 to 44 | 1.00 (Ref.) | 1.00 (Ref.) |
45 to 54 | 2.10 (1.78 to 2.47) | 1.44 (1.21 to 1.72) |
55 to 64 | 2.25 (1.92 to 2.64) | 1.38 (1.16 to 1.64) |
65 to 74 | 1.59 (1.35 to 1.86) | 1.12 (0.94 to 1.34) |
75 to 84 | 2.26 (1.88 to 2.71) | 1.27 (1.03 to 1.55) |
≥ 85 | 4.17 (3.28 to 5.32) | 1.90 (1.44 to 2.49) |
Women, age, yr |
18 to 44 | 1.00 (Ref.) | 1.00 (Ref.) |
45 to 54 | 1.54 (1.20 to 1.98) | 1.12 (0.85 to 1.47) |
55 to 64 | 1.55 (1.22 to 1.97) | 1.31 (1.01 to 1.69) |
65 to 74 | 2.26 (1.79 to 2.85) | 1.56 (1.21 to 2.00) |
75 to 84 | 3.01 (2.36 to 3.86) | 1.99 (1.53 to 2.60) |
≥ 85 | 3.16 (2.36 to 4.24) | 2.14 (1.55 to 2.95) |
Region of residence |
Urban | 1.00 (Ref.) | 1.00 (Ref.) |
Semi-urban | 1.10 (1.02 to 1.18) | 1.18 (1.08 to 1.28) |
Rural | 1.11 (1.02 to 1.20) | 1.23 (1.13 to 1.35) |
Charlson Comorbidity Index |
0 | 1.00 (Ref.) | 1.00 (Ref.) |
1 | 1.92 (1.79 to 2.06) | 1.23 (1.14 to 1.34) |
≥ 2 | 2.62 (2.38 to 2.87) | 1.42 (1.27 to 1.59) |
Opioid dispensed at index date |
Morphine | 1.00 (Ref.) | 1.00 (Ref.) |
Codeine | 1.13 (1.00 to 1.27) | 0.60 (0.52 to 0.69) |
Hydromorphone | 1.09 (1.01 to 1.18) | 1.26 (1.15 to 1.37) |
Oxycodone | 1.30 (1.19 to 1.43) | 1.24 (1.12 to 1.38) |
Butorphanol | 11.50 (1.20 to 110.63) | 5.35 (0.47 to 60.99) |
Fentanyl | 38.75 (32.19 to 46.65) | 1.17 (0.93 to 1.48) |
Meperidine | 0.75 (0.53 to 1.07) | 1.20 (0.83 to 1.72) |
Pentazocine | 2.16 (0.29 to 16.27) | 1.28 (0.14 to 11.35) |
Concomitant products at index date | 16.09 (12.44 to 20.80) | 1.34 (0.96 to 1.89) |
Concomitant products during index dispensing | 3.33 (2.79 to 3.98) | 2.10 (1.69 to 2.61) |
Mode of action |
Short-acting | 1.00 (Ref.) | 1.00 (Ref.) |
Long-acting | 23.42 (21.48 to 25.53) | 6.02 (5.31 to 6.84) |
Initial dose, MME/d |
< 30 | 1.00 (Ref.) | 1.00 (Ref.) |
30 to < 50 | 0.57 (0.53 to 0.61) | 0.91 (0.83 to 0.99) |
50 to < 90 | 0.46 (0.42 to 0.50) | 0.85 (0.76 to 0.95) |
≥ 90 | 1.20 (1.05 to 1.38) | 1.24 (1.04 to 1.47) |
Initial supply, d |
< 15 | 1.00 (Ref.) | 1.00 (Ref.) |
15 to 29 | 5.26 (4.79 to 5.79) | 2.22 (1.99 to 2.49) |
≥ 30 | 15.55 (14.38 to 16.82) | 4.22 (3.81 to 4.69) |
Prescriber’s specialty |
Family medicine | 1.00 (Ref.) | 1.00 (Ref.) |
Surgery | 0.17 (0.15 to 0.20) | 0.31 (0.27 to 0.37) |
Gynecology | 0.02 (0.01 to 0.09) | 0.09 (0.02 to 0.36) |
Emergency medicine | 0.37 (0.28 to 0.50) | 0.67 (0.50 to 0.91) |
Urology | 0.08 (0.04 to 0.17) | 0.16 (0.07 to 0.36) |
Dentistry | 0.02 (0.00 to 0.11) | 0.06 (0.01 to 0.44) |
Other | 0.08 (0.04 to 0.17) | 1.34 (1.17 to 1.52) |
Unknown | 0.73 (0.47 to 1.14) | 0.77 (0.47 to 1.25) |
Diagnoses or events associated with chronic or acute pain |
Accident, fracture or surgery claims | 1.00 (Ref.) | 1.00 (Ref.) |
Diagnosis associated with chronic pain | 5.17 (4.68 to 5.71) | 2.41 (2.16 to 2.69) |
Other diagnosis associated with pain | 1.70 (1.48 to 1.94) | 1.44 (1.24 to 1.66) |
Hospital or ED claim in 7 d before index date | 1.24 (1.07 to 1.43) | 1.21 (1.04 to 1.41) |
Unknown diagnosis | 4.20 (3.76 to 4.68) | 2.55 (2.26 to 2.88) |
Psychiatric disorder† |
Mood disorder | 1.76 (1.54 to 2.01) | 1.02 (0.86 to 1.21) |
Schizophrenia | 1.82 (1.57 to 2.11) | 0.93 (0.77 to 1.12) |
Anxiety disorder | 2.31 (2.04 to 2.62) | 1.06 (0.91 to 1.23) |
Other psychiatric disorder | 2.46 (2.23 to 2.72) | 1.08 (0.92 to 1.26) |
Dementia† | 4.15 (3.65 to 4.71) | 1.46 (1.20 to 1.79) |
Substance use disorder† | 1.85 (1.53 to 2.25) | 1.50 (1.20 to 1.88) |
Psychotropic drugs (in 12 mo before index date) |
None | 1.00 (Ref.) | 1.00 (Ref.) |
Benzodiazepines | 2.99 (2.81 to 3.18) | 1.57 (1.45 to 1.69) |
Antipsychotics | 2.68 (2.48 to 2.91) | 1.69 (1.53 to 1.88) |
Antidepressants | 2.41 (2.24 to 2.60) | 1.37 (1.25 to 1.50) |
NSAIDs (in 12 mo before index date) |
None | 1.00 (Ref.) | 1.00 (Ref.) |
Short-term (< 90 d) | 1.30 (1.21 to 1.41) | 1.23 (1.13 to 1.34) |
Long-term (≥ 90 d) | 3.86 (3.55 to 4.21) | 1.96 (1.77 to 2.18) |
Prescribed acetaminophen (in 12 mo before index date) |
None | 1.00 (Ref.) | 1.00 (Ref.) |
Short-term (< 90 d) | 2.43 (2.21 to 2.67) | 1.32 (1.18 to 1.47) |
Long-term (≥ 90 d) | 5.41 (5.01 to 5.84) | 2.05 (1.86 to 2.25) |
Prescribed acetaminophen–codeine (in 12 mo before index date) |
None | 1.00 (Ref.) | 1.00 (Ref.) |
Short-term (< 90 d) | 2.01 (1.81 to 2.22) | 1.44 (1.28 to 1.62) |
Long-term (≥ 90 d) | 15.57 (12.87 to 18.81) | 6.30 (4.99 to 7.96) |
Gabapentinoid (in 12 mo before index date) |
None | 1.00 (Ref.) | 1.00 (Ref.) |
Short-term (< 90 d) | 3.88 (3.45 to 4.37) | 1.84 (1.61 to 2.12) |
Long-term (≥ 90 d) | 5.19 (4.74 to 5.68) | 2.02 (1.81 to 2.25) |