A Retrospective Cohort Study of Long-Term Immediate-Release Hydrocodone/Acetaminophen Use and Acetaminophen Dosing Above the Food and Drug Administration Recommended Maximum Daily Limit Among Commercially Insured Individuals in the United States (2008-2013)
A Retrospective Cohort Study of Long-Term Immediate-Release Hydrocodone/Acetaminophen Use and Acetaminophen Dosing Above the Food and Drug Administration Recommended Maximum Daily Limit Among Commercially Insured Individuals in the United States (2008-2013)
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DOI：
10.1016/j.jpain.2015.03.004
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发表时间：
2015-06-01
期刊：
影响因子：
4
通讯作者：
Coplan, Paul
中科院分区：
文献类型：
--
作者：
DeVeaugh-Geiss, Angela;Kadakia, Aditi;Coplan, Paul
Immediate-release (IR) hydrocodone/acetaminophen is the most prescribed opioid in the United States; however, patterns of use, including long-term treatment and dose, are not well described. Duration of use, including the percentage of patients on long-term treatment (>90 days of continuous use), was assessed for patients newly prescribed IR hydrocodone/acetaminophen compared to other opioid analgesics in a national commercial insurance database (January 2008 September 2013). Though only a small percentage of IR hydrocodone/acetaminophen patients continued treatment long-term (1.7%), the number was large (104,839) and was nearly 5 times the number receiving extended-release (ER) morphine (n = 22,338) and nearly 4 times the number receiving ER oxycodone (n = 26,946) long-term. Using a less conservative allowable gap in treatment increased the number of patients meeting the criteria for long-term use (approximately 160,000 for IR hydrocodone/acetaminophen vs 20 and 60 mg/d. Moreover, approximately 15% of IR hydrocodone/acetaminophen patients (n > 900,000) were prescribed total daily acetaminophen doses exceeding 4 g (the limit recommended by the U.S. Food and Drug Administration) at their initial IR hydrocodone/acetaminophen prescription or any time during therapy.Perspective: Although most patients were prescribed IR hydrocodone/acetaminophen for acute pain, the number of patients prescribed long-term therapy exceeds the number of patients prescribed ER opioids. It is important to consider the benefits and risks inherent with long-term opioid therapy, whether with IR or ER opioids, to ensure safe use of these products. (C) 2015 The Authors. Published by Elsevier Inc. on behalf of the American Pain Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
