Opioid Prescribing Among Outpatients with Rheumatoid Arthritis

Study Objectives. To examine the outpatient opioid prescribing practices and the factors associated with opioid prescriptions in patient visits with rheumatoid arthritis (RA). Design. This cross-sectional study used the 2011-2016 National Ambulatory Medical Care Survey. Descriptive weighted analyses were used to examine the trends in opioid prescribing practices for RA. Multivariable logistic regression was used to examine the factors associated with opioid prescriptions among RA visits. Subjects. Adult patients (>18 years of age) with a primary diagnosis of RA based on the International Classification of Diseases. Results. According to the national surveys, an average of 4.45 (95% confidence interval [CI], 2.30-6.60) million office visits were made annually for RA. Approximately 24.28% of these visits involved opioid prescriptions. The RA visits involving opioid prescriptions increased from 1.43 million in 2011-2012 to 3.69 million in 2015-2016 (P<.0001). Being in the age group of 50-64years (odds ratio [OR] = 3.40; 95% CI, 1.29-9.00), being Hispanic or Latino (OR=2.92, 95% CI, 1.10-7.74), visiting primary physician (OR=4.67; 95% CI, 1.86-11.75), prescribing of muscle relaxants (OR=64.32; 95% CI, 9.71-426.09), acetaminophen (OR=93.40; 95% CI, 26.19-333.04), antidepressants (OR=6.10; 95% CI, 2.63-14.14), and glucocorticoids (OR=3.20; 95% CI, 1.61-6.38), were associated with an increased likelihood of receiving opioid prescriptions in RA. Conclusions. One in four adult RA visits resulted in opioid prescriptions, and the opioid visits more than doubled during the study period. Several patient and provider factors were associated with the opioid prescribing among RA visits. Understanding these prescribing practices can help to devise strategies for safe opioid prescribing practices in RA.