Prescribing Pattern of Analgesics in Colombia. Are there Differences between Capital Cities and Municipalities? A Cross-Sectional Study

Abstract

Background Analgesics provide multiple clinical benefits but they are not without risks. Objective The aim of this study was to compare the outpatient prescribing pattern of analgesics between cities and municipalities in Colombia and to identify the variables associated with prescribing opioid analgesics. Methods This was a cross-sectional study that identified the prescription of analgesics for outpatient use from a population database of 8.5 million Colombians. A descriptive, bivariate, and multivariate analysis was performed. Results A total of 573,248 patients were identified who had received prescriptions for an analgesic. Mean age was 46.5 ± 23.6 years and 65.7% were females. The most commonly prescribed analgesics were non-opioid analgesics, antispasmodics, and opioid analgesics. The average milligram equivalent of morphine was higher in capital cities than in municipalities. Age ≥ 65 years (odds ratio [OR] 2.60, 95% confidence interval [CI] 2.54-2.67), male sex (OR 1.09, 95% CI 1.07-1.11), dispensing in cities (OR 2.25, 95% CI 2.20-2.30) and experiencing chronic pain (OR 13.25, were associated with an increased risk of receiving an opioid analgesic. Conclusions Differences were found in the prescription of analgesics between capital cities and municipalities. The use of opioids does not appear to be in line with the recommendations for clinical practice, and they were mainly prescribed for elderly males with chronic non-oncological pain and for residents of capital cities.

Chronic pain and continuity of analgesic treatment during the COVID‐19 pandemic

“…The median age of these chronic pain patients was higher than that documented in other studies conducted in America and Europe, 8,9,12,15,16 while the predominance of women was consistent with that reported in other publications 1,5,8,9,12,15,16 . The geographical variation on analgesic drug usage has been reported previously in the country 17 . Among patients with chronic pain in Spain, Greece, Italy and the United Kingdom, the most frequently reported type of pain was of musculoskeletal origin, 3,5,18,19 consistent with the findings of this report.…”

“…1,5,8,9,12,15,16 The geographical variation on analgesic drug usage has been reported previously in the country. 17 Among patients with chronic pain in Spain, Greece, Italy and the United Kingdom, the most frequently reported type of pain was of musculoskeletal origin, 3,5,18,19 consistent with the findings of this report.…”

Potentially Inappropriate Use of Opioids in the Management of Migraine in Colombia

“…Finally, it was identified that almost all of the prescriptions were made by general practitioners, which provides an opportunity to implement continuing education and therapeutic update strategies for this group of professionals, in an effort to reduce potentially inappropriate opioid prescriptions. The findings in differences between regions have been previously described in pharmacoepidemiological studies, opening opportunities for the implementation of clinical practice guidelines and updates for physicians, especially those in regions with greater formulations [ 4 , 16 , 21 ].…”

“…The most widely used opioids for pain management in this group of patients were codeine + acetaminophen and tramadol, which have already been previously described in studies in Colombia [ 20 , 21 ]. This may be explained by doctors’ ignorance about the effectiveness of various antimigraine medications and analgesics, accompanied by a feeling of greater confidence in the use of opioids for any clinical condition that causes pain [ 11 , 14 , 22 ].…”