Can an opioid prescription for back pain reflect limits on other treatment options?

The study counted office visits

Researchers used US office-visit data from 2012 through 2017 to study opioid prescribing for back pain. They examined selected conditions and medications that might affect which analgesics a clinician considered. An opioid was prescribed at about 4% of visits in their overall model.

Clinical alternatives can shape the record

The analysis identified associations involving kidney disease and anticoagulant or antiplatelet use. Those characteristics can affect what other analgesic options a clinician considers. A database association cannot identify the reasoning behind a particular prescription or establish that a documented condition actually drove the decision.

What a record review can establish

Compare the medication list with the clinician’s assessment of pain, relevant comorbidities, prior treatments and documented alternatives. Then distinguish the decision to prescribe from evidence that a drug was dispensed or taken. The visit-based study measured prescribing decisions, so its figures do not describe individual dosing or impairment.

Source paper

Keller et al., BMC Family Practice (2021) · Full text

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