Prevalence of Opioid and Benzodiazepine Prescriptions for Osteoarthritis

Abstract

Background Opioids and benzodiazepines are commonly used for management of osteoarthritis despite evidence‐based recommendations to the contrary. This study aims to quantify the prevalence of opioid and benzodiazepine prescribing for osteoarthritis. Additionally, we aim to characterize risk factors for prescription drug misuse, abuse, and diversion among this population. Methods We conducted a descriptive analysis of adult outpatient encounters with a primary diagnosis of osteoarthritis during a one‐year period at a large healthcare system, excluding cancer and outpatient procedures. Demographic data, prescription data, and patient‐specific risk factors were collected. Descriptive analysis was conducted to characterize arthritis patients who received and did not receive prescription opioids. Results During one year, our system had 31,123 outpatient encounters for osteoarthritis. Opioids and benzodiazepines were prescribed for nearly 27% of the encounters (n=8,420). 43% of the encounters involved patients >65 years old. Hydrocodone‐acetaminophen was the most common medication prescribed (34.3%). Most prescriptions were written by pain specialists (53%). 35.5% had a risk factor for prescription misuse, the most prevalent being “early refill” and a history of receiving 3 or more prescriptions in the past month. Conclusions Opioids and benzodiazepines continue to be written for osteoarthritis. These prescriptions may pose a risk for adverse outcomes since greater than one in 5 patients receiving prescriptions had a risk factor for misuse. Continued efforts to improve compliance with evidence‐based guidelines as well as multimodal and alternative pain management pathways are critical to help curb the use of opioids for management of osteoarthritis‐related pain.