Table 3. Prevalence and Absolute Differences in Patients With Prescription Opioids for Management of Specific Pain Diagnoses by Obesity Among 555 444 Patients Aged 35 to 64 Years, athenahealth Network, 2015-2017a.
| Pain diagnosis recorded with prescription opioidsb | Prevalence, % (95% CI) | Obese vs normal | |||
|---|---|---|---|---|---|
| Overall | Normal (BMI 20.0-24.9) | Obese (BMI>30) | Absolute differences, % (95% CI) | Contribution to overall differences, % | |
| Any pain condition | 16.6 (16.5-16.7) | 13.9 (13.7-14.1) | 18.5 (18.3-18.6) | 4.6 (4.3-4.9) | 100 |
| Other joint disorders | 2.7 (2.6-2.7) | 1.9 (1.8-2.0) | 3.2 (3.1-3.2) | 1.2 (1.1-1.3) | 26.6 |
| Osteoarthritis | 1.3 (1.3-1.4) | 0.86 (0.80-0.92) | 1.6 (1.6-1.7) | 0.78 (0.70-0.85) | 16.9 |
| Other back disorders | 3.0 (3.0-3.1) | 2.7 (2.6-2.8) | 3.2 (3.1-3.2) | 0.46 (0.34-0.58) | 9.9 |
| Radiculitis | 0.72 (0.70-0.74) | 0.58 (0.53-0.63) | 0.80 (0.77-0.83) | 0.21 (0.16-0.27) | 4.6 |
| Backache | 0.74 (0.72-0.76) | 0.63 (0.58-0.68) | 0.81 (0.78-0.85) | 0.18 (0.12-0.25) | 4.0 |
| Pain in limb | 0.56 (0.54-0.58) | 0.45 (0.41-0.49) | 0.63 (0.60-0.66) | 0.18 (0.13-0.23) | 3.9 |
| Myopathy | 0.79 (0.77-0.81) | 0.71 (0.66-0.76) | 0.84 (0.80-0.87) | 0.12 (0.06-0.19) | 2.7 |
| Peripheral nerve disorder | 0.60 (0.58-0.62) | 0.54 (0.49-0.58) | 0.66 (0.63-0.69) | 0.12 (0.07-0.18) | 2.7 |
| Cardiovascular and circulatory diseases | 0.36 (0.34-0.37) | 0.29 (0.25-0.32) | 0.41 (0.38-0.43) | 0.12 (0.08-0.16) | 2.6 |
| Noncervical spinal stenosis | 0.27 (0.26-0.29) | 0.20 (0.17-0.23) | 0.32 (0.30-0.34) | 0.12 (0.08-0.16) | 2.6 |
| Sciatica | 0.42 (0.40-0.44) | 0.34 (0.31-0.38) | 0.45 (0.42-0.47) | 0.11 (0.06-0.15) | 2.3 |
| Other digestive diseases | 0.73 (0.71-0.75) | 0.67 (0.62-0.72) | 0.76 (0.73-0.80) | 0.10 (0.04-0.16) | 2.2 |
| Other injury | 0.49 (0.47-0.51) | 0.45 (0.41-0.49) | 0.53 (0.50-0.55) | 0.08 (0.03-0.13) | 1.6 |
| Disorders of bone and cartilage | 0.29 (0.28-0.30) | 0.25 (0.22-0.28) | 0.31 (0.29-0.33) | 0.06 (0.02-0.10) | 1.3 |
| Acute pain | 0.20 (0.19-0.21) | 0.18 (0.15-0.20) | 0.22 (0.20-0.24) | 0.04 (0.01-0.08) | 0.9 |
| Generalized pain | 0.21 (0.20-0.22) | 0.19 (0.16-0.22) | 0.22 (0.21-0.24) | 0.03 (0.00-0.07) | 0.7 |
| Diseases of connective tissue | 0.17 (0.16-0.18) | 0.15 (0.13-0.18) | 0.18 (0.17-0.20) | 0.03 (0.00-0.06) | 0.6 |
| Degeneration of intervertebral disc | 0.80 (0.78-0.82) | 0.79 (0.73-0.85) | 0.82 (0.78-0.85) | 0.03 (−0.04 to 0.09) | 0.6 |
| Chronic pain | 1.1 (1.1-1.2) | 1.1 (1.1-1.2) | 1.2 (1.1-1.2) | 0.01 (−0.07 to 0.09) | 0.3 |
| Failed back surgery | 0.20 (0.19-0.22) | 0.20 (0.17-0.23) | 0.20 (0.18-0.22) | 0.00 (−0.04 to 0.03) | −0.1 |
| Pain in thoracic spine | 0.16 (0.15-0.17) | 0.17 (0.15-0.20) | 0.17 (0.15-0.18) | −0.01 (−0.04 to 0.02) | −0.2 |
| Other cervical region disorders | 0.28 (0.27-0.30) | 0.29 (0.25-0.32) | 0.28 (0.26-0.30) | −0.01 (−0.05 to 0.03) | −0.2 |
| Displacement of intervertebral disc | 0.50 (0.48 to 0.52) | 0.51 (0.46 to 0.55) | 0.50 (0.47 to 0.52) | −0.01 (−0.06 to 0.05) | −0.2 |
| Headache syndromes | 0.82 (0.79 to 0.84) | 0.86 (0.81 to 0.92) | 0.80 (0.76 to 0.83) | −0.07 (−0.13 to 0.00) | −1.5 |
| Cervicalgia | 0.75 (0.73 to 0.77) | 0.83 (0.77 to 0.88) | 0.71 (0.68 to 0.74) | −0.12 (−0.19 to −0.05) | −2.6 |
Abbreviation: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared).
a
Adjusted for age, sex, race/ethnicity, region, urbanicity, and health insurance. Patients with underweight BMI (18.5-19.9) were excluded.
b
eTable 4 and eTable 5 in the Supplement provide International Classification of Diseases, Ninth Revision, and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes used to diagnose each pain diagnosis. Patients could record multiple pain diagnosis claims prior to receiving prescription opioids. A total of 14 845 patients (15.8%) with prescription opioids also recorded no diagnosis claim within 7 days prior to prescription.