A claims analysis of the utilization of tramadol for acute pain in patients prescribed buprenorphine/naloxone for opioid use disorder

Authors

  • Kellye Donovan, PharmD, PhD, MHA
  • Stephen Kogut, PhD, MBA
  • Ashley Buchanan, DrPH, MS
  • Xuerong Wen, PhD, MPH
  • Robert Crausman, MD, MMS

DOI:

https://doi.org/10.5055/jom.2018.0473

Keywords:

buprenorphine, suboxone, medication-assisted therapy, tramadol, opioid use disorder

Abstract

Objective: To determine the prevalence of tramadol prescribing among commercially insured adults receiving medication-assisted therapy (MAT) with buprenorphine/naloxone.

Design: The authors conducted a cross-sectional descriptive study to evaluate the use of tramadol among patients prescribed buprenorphine/suboxone for MAT.

Setting: This study utilized data from 2010 to 2013 Optum® Clinformatics® Data Mart. This cohort is an administrative health claims database from a large national insurer. These data included pharmacy and medical care utilization and information describing patient enrollment.

Patients/participants: Patients were 12-64 years of age and had complete and available medical, pharmacy, and administrative records in the Optum Clinformatics Data Mart during the study period.

Main outcome measures: Patients who received at least one paid claim for buprenorphine/naloxone from 2010 to 2013 and also received at least one overlapping pharmacy dispensing for tramadol were identified for analysis. The authors determined if the concurrent buprenorphine/naloxone and tramadol dispensings were from the same or a different prescriber.

Results: In this analysis of 18,734 US commercially insured patients receiving MAT with buprenorphine/naloxone, the authors identified 1,198 (6.4 percent) patients who received at least one overlapping dispensing for tramadol during a 4-year period spanning 2010-2013. Among these patients, 266 (1.42 percent) were co-prescribed buprenorphine/naloxone and tramadol from the same provider.

Conclusions: These results suggest that the use of tramadol among patients receiving buprenorphine/naloxone is not uncommon. Further study is warranted to further determine the benefits and risks associated with the use of tramadol for pain management among patients prescribed buprenorphine/naloxone.

Author Biographies

Kellye Donovan, PharmD, PhD, MHA

Program in Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island

Stephen Kogut, PhD, MBA

Program in Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island

Ashley Buchanan, DrPH, MS

Program in Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island

Xuerong Wen, PhD, MPH

Program in Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island

Robert Crausman, MD, MMS

President Trumed Medical Offices, Fall River, Massachusetts; Clinical Professor, Alpert School of Medicine, Brown University, Providence, Rhode Island

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Published

11/01/2018

How to Cite

Donovan, PharmD, PhD, MHA, K., S. Kogut, PhD, MBA, A. Buchanan, DrPH, MS, X. Wen, PhD, MPH, and R. Crausman, MD, MMS. “A Claims Analysis of the Utilization of Tramadol for Acute Pain in Patients Prescribed buprenorphine/Naloxone for Opioid Use Disorder”. Journal of Opioid Management, vol. 14, no. 6, Nov. 2018, pp. 407-13, doi:10.5055/jom.2018.0473.