Prevalence and Its Correlation with Sustained Opioid Use in Korea: A Group-Based Trajectory Analysis

ABSTRACT

Long-term use of opioid analgesics can lead to addiction and opioid-related death. We aimed to present the pattern of long-term opioid utilization and identify factors associated with it by using group-based trajectory modeling. We used the nationwide health insurance claims database from 2009 to 2013. Multinomial logistic regression was conducted to estimate the adjusted odds ratio (aOR) and its 95% confidence intervals (CI) for the risk of sustained opioid use associated with various clinical factors. Among 15,327 patients prescribed with opioids, three trajectories were identified: high-sustained users (4.6%, n = 713), early discontinuation (84.2%, n = 12,916), and slow discontinuation (11.2%, n = 1,698). A higher proportion of women (72.8% vs. 58.4%) and elderly patients (55.9% vs. 22.1%) were found in the high-sustained users than the early discontinuation group. Depression (aOR 3.55, 95% CI 1.99–6.35) and epilepsy (aOR 10.12, CI 4.72–21.67) were the two highest comorbidities associated with sustained opioid use in the high-sustained users when compared to the early discontinuation group. Among chronic non-cancer patients, 4.6% were prescribed opioids consistently. Both healthcare providers and patients should be aware of the factors associated with sustained opioid use when prescribing it to patients with mental-related conditions, and its consequent adverse events should be carefully monitored.

KEYWORDS:

• Group-based trajectory modeling
• trajectory analysis
• opioid analgesics
• opioid adherence

Acknowledgments

Mr. Yoon wrote the first draft of the manuscript. Each author listed on the manuscript has seen and approved the submission of this version of the manuscript and takes full responsibility for the manuscript.

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

No specific funding was granted.