OBJECTIVES:

To investigate the use of prescription opioids in Korean elderly patients using the Health Insurance Review and Assessment Service-Aged Patient Sample (HIRA-APS) data.

METHODS:

We conducted a cross-sectional study using 2014–2016 HIRA-APS data, a representative sample of patients aged ≥65 in Korea (20% of elderly patients). For each year, cancer patients and non-cancer pain (NCP) patients (osteoarthritis, back/neck pain, osteoporosis, or headache/migraine) were identified and their opioid prescriptions (buprenorphine, fentanyl, hydrocodone, hydromorphone, morphine, oxycodone, and pethidine) were analyzed. Total yearly dose in population was calculated as the sum of opioid dose prescribed in the year divided by number of individuals in HIRA-APS data. Utilization pattern was measured by the number of prescriptions, opioid types, days supplied, and daily and yearly dose calculated by defined daily dose (DDD).

RESULTS:

Between 2014 and 2016, the total yearly dose of opioids in HIRA-APS population increased in both cancer patients and NCP patients (715–1184 and 286–321 DDD/1000 population, respectively). Opioid utilization per patient was slightly increased or stable during the study period (days supplied: 38.3–39.1 and 15.4–17.4 days; mean daily dose: 0.32–0.30 and 0.19–0.18 DDD; mean yearly dose: 22.3–34.6 and 5.1–5.3 DDD; in cancer patients and NCP patients, respectively). Proportion of patients prescribed opioids has slightly decreased in cancer patients (34.7–33.8%), while it has increased in NCP patients (9.8–10.7%). In 2016, pethidine was the most commonly prescribed opioid in both cancer (21.0%) and NCP patients (30.1%), followed by morphine short-acting and fentanyl long-acting in cancer patients and buprenorphine in NCP patients. Among NCP patients, 73.4% had multiple pain types and 19.5% had back/neck pain.

CONCLUSIONS:

Total yearly dose of prescription opioids in Korean elderly patients has increased between 2014 and 2016, while the utilization per patient was generally stable over that period.