Population- and individual-level trajectories of opioid prescription patterns among adults with cerebral palsy: a retrospective cohort study

Reviewed by Christa Weigel

Citation: Whitney DG, Peterson MD, Hurvitz EA. Population- and individual-level trajectories of opioid prescription patterns among adults with cerebral palsy: a retrospective cohort study. Int J Clin Pharm. 2023 Mar 10:1–12. doi: 10.1007/s11096-023-01553-5. Epub ahead of print. PMID: 36897434; PMCID: PMC9999316.

Study type/population: A multi-level, nationwide retrospective cohort study comparing opioid exposure and trajectory patterns (captured using prescription information available in pharmacy claims) for adults >18 years old with cerebral palsy (CP; n=13,929) compared to without CP (n=278,538).

Key findings: Adults with CP had a higher prevalence of exposure to opioids across the 7-year study period, suggesting that adults with CP versus without CP are more likely to be prescribed a higher monthly volume for a longer period of time. There were multiple different individual-level opioid prescription trajectory patterns, ranging from acute-repeated to chronic-continuous, pointing to variability in how they are prescribed.  The ‘consistently high’ trajectory group (high number of days supplied with opioids) for adults with CP had a higher proportion of individuals with co-occurring epilepsy and/or intellectual disabilities, associated with greater medical complexity.

Translation to practice: Management of pain is important for adults with CP, as it has a negative impact on quality of life, daily function, mental health and sleep. However, potential inadvertent side effects from greater levels of opioid exposure should be considered, as opioid use may create or exacerbate other health issues and complicate long-term clinical management. Identification of a risk-benefit balance for opioid use is needed.