Incidence of tramadol shopping behavior in a retrospective cohort of chronic non-cancer pain patients in France
2016; Wiley; Volume: 25; Issue: 9 Linguagem: Inglês
10.1002/pds.4056
ISSN1099-1557
AutoresChouki Chenaf, Jean‐Luc Kaboré, Jessica Delorme, Bruno Pereira, Aurélien Mulliez, Lucie Roche, Alain Eschalier, Noémie Delage, Nicolas Authier,
Tópico(s)Musculoskeletal pain and rehabilitation
ResumoPharmacoepidemiology and Drug SafetyVolume 25, Issue 9 p. 1088-1098 Original Report Incidence of tramadol shopping behavior in a retrospective cohort of chronic non-cancer pain patients in France Chouki Chenaf, Corresponding Author Chouki Chenaf INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceCorrespondence to: C. Chenaf, Centre Hospitalier Universitaire de Clermont-Ferrand, Service de Pharmacologie Médicale, BP69, 63003 Clermont-Ferrand, France. Email: chouki.chenaf@udamail.frSearch for more papers by this authorJean-Luc Kabore, Jean-Luc Kabore INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceFirst co-authors, contributed equally.Search for more papers by this authorJessica Delorme, Jessica Delorme INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceSearch for more papers by this authorBruno Pereira, Bruno Pereira CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, Clermont-Ferrand, FranceSearch for more papers by this authorAurélien Mulliez, Aurélien Mulliez CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, Clermont-Ferrand, FranceSearch for more papers by this authorLucie Roche, Lucie Roche INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceSearch for more papers by this authorAlain Eschalier, Alain Eschalier INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, France CHU Clermont-Ferrand Centre d'Evaluation et de Traitement de la Douleur (CETD), Service de Pharmacologie Médicale, Clermont-Ferrand, France Institut Analgesia, Faculté de Médecine, Clermont-Ferrand, FranceSearch for more papers by this authorNoémie Delage, Noémie Delage INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand Centre d'Evaluation et de Traitement de la Douleur (CETD), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceSearch for more papers by this authorNicolas Authier, Nicolas Authier INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, France CHU Clermont-Ferrand Centre d'Evaluation et de Traitement de la Douleur (CETD), Service de Pharmacologie Médicale, Clermont-Ferrand, France Institut Analgesia, Faculté de Médecine, Clermont-Ferrand, FranceSearch for more papers by this author Chouki Chenaf, Corresponding Author Chouki Chenaf INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceCorrespondence to: C. Chenaf, Centre Hospitalier Universitaire de Clermont-Ferrand, Service de Pharmacologie Médicale, BP69, 63003 Clermont-Ferrand, France. Email: chouki.chenaf@udamail.frSearch for more papers by this authorJean-Luc Kabore, Jean-Luc Kabore INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceFirst co-authors, contributed equally.Search for more papers by this authorJessica Delorme, Jessica Delorme INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceSearch for more papers by this authorBruno Pereira, Bruno Pereira CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, Clermont-Ferrand, FranceSearch for more papers by this authorAurélien Mulliez, Aurélien Mulliez CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, Clermont-Ferrand, FranceSearch for more papers by this authorLucie Roche, Lucie Roche INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceSearch for more papers by this authorAlain Eschalier, Alain Eschalier INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, France CHU Clermont-Ferrand Centre d'Evaluation et de Traitement de la Douleur (CETD), Service de Pharmacologie Médicale, Clermont-Ferrand, France Institut Analgesia, Faculté de Médecine, Clermont-Ferrand, FranceSearch for more papers by this authorNoémie Delage, Noémie Delage INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand Centre d'Evaluation et de Traitement de la Douleur (CETD), Service de Pharmacologie Médicale, Clermont-Ferrand, FranceSearch for more papers by this authorNicolas Authier, Nicolas Authier INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, Clermont-Ferrand, France CHU Clermont-Ferrand Centre d'Evaluation et de Traitement de la Douleur (CETD), Service de Pharmacologie Médicale, Clermont-Ferrand, France Institut Analgesia, Faculté de Médecine, Clermont-Ferrand, FranceSearch for more papers by this author First published: 30 June 2016 https://doi.org/10.1002/pds.4056Citations: 17 Institutional URL: www.u-clermont1.fr/neuro-dol.html Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Purpose Opioid analgesic use in chronic non-cancer pain (CNCP) is increasingly prevalent, but the benefits and risks are inadequately understood. In France, tramadol is one of the most used prescription opioids, but studies on its misuse liability in CNCP are still lacking. The aim was to assess the incidence of tramadol shopping behavior in CNCP patients and to identify the associated risk factors. Methods A retrospective cohort of CNCP patients aged 18 years and older treated by tramadol for at least six consecutive months between 2005 and 2013 from a sample of the French Health Insurance database was established. Doctor shopping was defined as at least 1 day of overlapping prescriptions written by two or more different prescribers and filled in at least three different pharmacies. Results A total of 3505 CNCP patients were included with a majority of women (66.4%) and a mean age of 66.4 ± 14.7 years. The median tramadol treatment duration was 260 [interquartile range: 211–356] days. The 1-year incidence rate of tramadol shopping behavior was 1.0% [95%CI: 0.7–1.5]. On multivariate analysis, risk factors associated with tramadol shopping behavior were age (hazard ratio [HR] = 7.4 [95%CI: 2.8–19.7] for age <40, HR = 2.8 [95%CI: 1.0–7.7] for 40 ≤ age < 50, versus age ≥50), low-income status (HR = 8.5 [95%CI: 3.6–20.5]), and prior use of strong opioids (HR = 5.7 [95%CI: 1.9–17.0]). Conclusion Tramadol shopping behavior incidence appears low in CNCP patients but may represent a public health concern given the widespread use of tramadol. Education and best monitoring of high-risk patients are needed to reduce doctor shopping. Copyright © 2016 John Wiley & Sons, Ltd. Citing Literature Volume25, Issue9September 2016Pages 1088-1098 RelatedInformation
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