Opioid Prescribing for Osteoarthritis: Cross-Sectional Survey among Primary Care Physicians, Rheumatologists, and Orthopaedic Surgeons

Thomas J. Schnitzer, Rebecca L. Robinson*, Lars Viktrup, Joseph C. Cappelleri, Andrew G. Bushmakin, Leslie Tive, Mia Berry, Chloe Walker, James Jackson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Opioids are often prescribed for osteoarthritis (OA) pain, despite recommendations to limit use due to minimal benefits and associated harms. This study aimed to assess physicians’ practice patterns and perceptions regarding opioids by specialty one year following the Centers for Disease Control and Prevention (CDC) published guidance on opioid prescribing. The 139/153 (90.8%) physicians who reported prescribing opioids in the previous year reported decreased prescribing for mild OA (51.3%, 26.5% and 33.3% of primary care physicians, rheumatologists, and orthopaedic surgeons, respectively), moderate OA (50.0%, 47.1% and 48.1%) and severe OA (43.6%, 41.2% and 44.4%). Prescribing changes were attributed to the CDC guidelines for 58.9% of primary care physicians, 59.1% of rheumatologists, and 73.3% of orthopaedic surgeons. Strong opioids were mostly reserved as third-line treatment. Although treatment effectiveness post-CDC guidelines was not assessed, perceptions of efficacy and quality of life with opioids significantly differed across specialties, whereas perceptions of safety, convenience/acceptability and costs did not. Physicians generally agreed on the barriers to opioid prescribing, with fear of addiction and drug abuse being the most important. Across specialties, physicians reported decreased opioid prescribing for OA, irrespective of OA severity, and in most cases attributed changes in prescribing to the CDC guideline.

Original languageEnglish (US)
Article number589
JournalJournal of Clinical Medicine
Volume12
Issue number2
DOIs
StatePublished - Jan 2023

Funding

Thomas J Schnitzer reports clinical research study support (Pfizer, Lilly, Regeneron, Galapagos, Taiwan Liposome Corporation, Anika Therapeutics) and fees for consultancy/advisory boards (Pfizer, Lilly, GSK, AstraZeneca, Galapagos, Merck). Rebecca L Robinson and Lars Viktrup are employees and stockholders of Eli Lilly and Company. Andrew Bushmakin, Joseph C Cappelleri, and Leslie Tive are employees of Pfizer Inc. with stock and/or stock options. Mia Berry, Chloe Walker, and James Jackson are employees of Adelphi Real World, which received funding from Pfizer Inc. and Eli Lilly and Company to conduct the study.

Keywords

  • addiction
  • centers for disease control and prevention
  • prescription analgesic
  • real-world clinical practice
  • tramadol
  • treatment guidelines
  • treatment patterns

ASJC Scopus subject areas

  • General Medicine

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