Prescription Dispensing Patterns Before and After a Workers' Compensation Claim: An Historical Cohort Study of Workers With Low Back Pain Injuries in British Columbia

J Occup Environ Med. 2018 Jul;60(7):644-655. doi: 10.1097/JOM.0000000000001311.

Abstract

Objective: Compare prescription dispensing before and after a work-related low back injury.

Methods: Descriptive analyses were used to describe opioid, nonsteroidal anti-inflammatory drug (NSAID), and skeletal muscle relaxant (SMR) dispensing 1 year pre- and post-injury among 97,124 workers in British Columbia with new workers' compensation low back claims from 1998 to 2009.

Results: Before injury, 19.7%, 21.2%, and 6.3% were dispensed opioids, NSAIDs, and SMRs, respectively, increasing to 39.0%, 50.2%, and 28.4% after. Median time to first post-injury prescription was less than a week. Dispensing was stable pre-injury, followed by a sharp increase within 8 weeks post-injury. Dispensing dropped thereafter, but remained elevated nearly a year post-injury, an increase attributable to less than 2% of claimants.

Conclusion: These drug classes are commonly dispensed, particularly shortly after injury and dispensing is of short duration for most, though a small subgroup receives prolonged courses.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Back Injuries / complications
  • Back Injuries / drug therapy*
  • British Columbia
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Humans
  • Low Back Pain / drug therapy*
  • Low Back Pain / etiology
  • Male
  • Middle Aged
  • Neuromuscular Agents / therapeutic use
  • Occupational Injuries / complications
  • Occupational Injuries / drug therapy*
  • Time Factors
  • Workers' Compensation*
  • Young Adult

Substances

  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Neuromuscular Agents

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