The association of tobacco use with prescription of muscle relaxants, benzodiazepines, and opioid analgesics for non-cancer pain

Hiroko Takaki, Ichiro Ieiri, Hidetoshi Shibuta, Daisuke Onozuka, Akihito Hagihara

研究成果: ジャーナルへの寄稿記事

抄録

BACKGROUND AND OBJECTIVES: Tobacco use and co-prescription of sedative hypnotics are risk factors for misuse of prescribed opioids among patients with non-cancer pain. However, the association between tobacco use and these co-prescriptions has not been clarified. We aimed to assess differences in the prescription and co-prescription rates of opioid analgesics with muscle relaxants and/or benzodiazepines between tobacco users and non-users.

METHODS: Visit data were obtained from the 2006 to 2009 National Ambulatory Medical Care Survey, an annual cross-sectional survey of visits to office-based physicians in outpatient settings in the United States. Our sample patients were aged ≥18 years and diagnosed with non-cancer back and neck pain. The χ2 test and multiple logistic regression analysis were used to assess bivariate and multivariate associations between prescription or co-prescription rates and tobacco use status.

RESULTS: We analyzed a total of 114,199,536 weighted visits (unweighted number: 3,521). Significant odds ratios (ORs) of tobacco users (vs non-users) for medical prescriptions were as follows: opioid analgesics, OR 2.14, 95% confidence interval (CI) 1.64-2.80; muscle relaxants and opioid analgesics, OR 2.57, 95%CI 1.76-3.74; benzodiazepines and opioid analgesics, OR 3.66, 95%CI 2.11-6.35, and muscle relaxants, benzodiazepines, and opioid analgesics, OR 7.02, 95%CI 2.98-16.57.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Tobacco users were more likely to receive prescriptions for opioid analgesics with muscle relaxants and/or benzodiazepines than non-users. Healthcare professionals need to limit co-prescription of opioid analgesics with muscle relaxants and/or benzodiazepines among tobacco users and provide a comprehensive approach to pain management. (Am J Addict 2019;XX:1-8).

元の言語英語
ジャーナルAmerican Journal on Addictions
DOI
出版物ステータス印刷前のE-pub - 1 9 2019

Fingerprint

Tobacco Use
Benzodiazepines
Opioid Analgesics
Prescriptions
Pain
Muscles
Odds Ratio
Tobacco
Confidence Intervals
Health Care Surveys
Office Visits
Physicians' Offices
Neck Pain
Pain Management
Back Pain
Hypnotics and Sedatives
Outpatients
Cross-Sectional Studies
Logistic Models
Regression Analysis

これを引用

The association of tobacco use with prescription of muscle relaxants, benzodiazepines, and opioid analgesics for non-cancer pain. / Takaki, Hiroko; Ieiri, Ichiro; Shibuta, Hidetoshi; Onozuka, Daisuke; Hagihara, Akihito.

:: American Journal on Addictions, 09.01.2019.

研究成果: ジャーナルへの寄稿記事

@article{53a05cecf79345b991df4a27429b8468,
title = "The association of tobacco use with prescription of muscle relaxants, benzodiazepines, and opioid analgesics for non-cancer pain",
abstract = "BACKGROUND AND OBJECTIVES: Tobacco use and co-prescription of sedative hypnotics are risk factors for misuse of prescribed opioids among patients with non-cancer pain. However, the association between tobacco use and these co-prescriptions has not been clarified. We aimed to assess differences in the prescription and co-prescription rates of opioid analgesics with muscle relaxants and/or benzodiazepines between tobacco users and non-users.METHODS: Visit data were obtained from the 2006 to 2009 National Ambulatory Medical Care Survey, an annual cross-sectional survey of visits to office-based physicians in outpatient settings in the United States. Our sample patients were aged ≥18 years and diagnosed with non-cancer back and neck pain. The χ2 test and multiple logistic regression analysis were used to assess bivariate and multivariate associations between prescription or co-prescription rates and tobacco use status.RESULTS: We analyzed a total of 114,199,536 weighted visits (unweighted number: 3,521). Significant odds ratios (ORs) of tobacco users (vs non-users) for medical prescriptions were as follows: opioid analgesics, OR 2.14, 95{\%} confidence interval (CI) 1.64-2.80; muscle relaxants and opioid analgesics, OR 2.57, 95{\%}CI 1.76-3.74; benzodiazepines and opioid analgesics, OR 3.66, 95{\%}CI 2.11-6.35, and muscle relaxants, benzodiazepines, and opioid analgesics, OR 7.02, 95{\%}CI 2.98-16.57.CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Tobacco users were more likely to receive prescriptions for opioid analgesics with muscle relaxants and/or benzodiazepines than non-users. Healthcare professionals need to limit co-prescription of opioid analgesics with muscle relaxants and/or benzodiazepines among tobacco users and provide a comprehensive approach to pain management. (Am J Addict 2019;XX:1-8).",
author = "Hiroko Takaki and Ichiro Ieiri and Hidetoshi Shibuta and Daisuke Onozuka and Akihito Hagihara",
note = "{\circledC} 2019 American Academy of Addiction Psychiatry.",
year = "2019",
month = "1",
day = "9",
doi = "10.1111/ajad.12830",
language = "English",
journal = "American Journal on Addictions",
issn = "1055-0496",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - The association of tobacco use with prescription of muscle relaxants, benzodiazepines, and opioid analgesics for non-cancer pain

AU - Takaki, Hiroko

AU - Ieiri, Ichiro

AU - Shibuta, Hidetoshi

AU - Onozuka, Daisuke

AU - Hagihara, Akihito

N1 - © 2019 American Academy of Addiction Psychiatry.

PY - 2019/1/9

Y1 - 2019/1/9

N2 - BACKGROUND AND OBJECTIVES: Tobacco use and co-prescription of sedative hypnotics are risk factors for misuse of prescribed opioids among patients with non-cancer pain. However, the association between tobacco use and these co-prescriptions has not been clarified. We aimed to assess differences in the prescription and co-prescription rates of opioid analgesics with muscle relaxants and/or benzodiazepines between tobacco users and non-users.METHODS: Visit data were obtained from the 2006 to 2009 National Ambulatory Medical Care Survey, an annual cross-sectional survey of visits to office-based physicians in outpatient settings in the United States. Our sample patients were aged ≥18 years and diagnosed with non-cancer back and neck pain. The χ2 test and multiple logistic regression analysis were used to assess bivariate and multivariate associations between prescription or co-prescription rates and tobacco use status.RESULTS: We analyzed a total of 114,199,536 weighted visits (unweighted number: 3,521). Significant odds ratios (ORs) of tobacco users (vs non-users) for medical prescriptions were as follows: opioid analgesics, OR 2.14, 95% confidence interval (CI) 1.64-2.80; muscle relaxants and opioid analgesics, OR 2.57, 95%CI 1.76-3.74; benzodiazepines and opioid analgesics, OR 3.66, 95%CI 2.11-6.35, and muscle relaxants, benzodiazepines, and opioid analgesics, OR 7.02, 95%CI 2.98-16.57.CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Tobacco users were more likely to receive prescriptions for opioid analgesics with muscle relaxants and/or benzodiazepines than non-users. Healthcare professionals need to limit co-prescription of opioid analgesics with muscle relaxants and/or benzodiazepines among tobacco users and provide a comprehensive approach to pain management. (Am J Addict 2019;XX:1-8).

AB - BACKGROUND AND OBJECTIVES: Tobacco use and co-prescription of sedative hypnotics are risk factors for misuse of prescribed opioids among patients with non-cancer pain. However, the association between tobacco use and these co-prescriptions has not been clarified. We aimed to assess differences in the prescription and co-prescription rates of opioid analgesics with muscle relaxants and/or benzodiazepines between tobacco users and non-users.METHODS: Visit data were obtained from the 2006 to 2009 National Ambulatory Medical Care Survey, an annual cross-sectional survey of visits to office-based physicians in outpatient settings in the United States. Our sample patients were aged ≥18 years and diagnosed with non-cancer back and neck pain. The χ2 test and multiple logistic regression analysis were used to assess bivariate and multivariate associations between prescription or co-prescription rates and tobacco use status.RESULTS: We analyzed a total of 114,199,536 weighted visits (unweighted number: 3,521). Significant odds ratios (ORs) of tobacco users (vs non-users) for medical prescriptions were as follows: opioid analgesics, OR 2.14, 95% confidence interval (CI) 1.64-2.80; muscle relaxants and opioid analgesics, OR 2.57, 95%CI 1.76-3.74; benzodiazepines and opioid analgesics, OR 3.66, 95%CI 2.11-6.35, and muscle relaxants, benzodiazepines, and opioid analgesics, OR 7.02, 95%CI 2.98-16.57.CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Tobacco users were more likely to receive prescriptions for opioid analgesics with muscle relaxants and/or benzodiazepines than non-users. Healthcare professionals need to limit co-prescription of opioid analgesics with muscle relaxants and/or benzodiazepines among tobacco users and provide a comprehensive approach to pain management. (Am J Addict 2019;XX:1-8).

U2 - 10.1111/ajad.12830

DO - 10.1111/ajad.12830

M3 - Article

JO - American Journal on Addictions

JF - American Journal on Addictions

SN - 1055-0496

ER -