P415 Trends in narcotic and corticosteroid prescriptions in patients with inflammatory bowel disease in the United States ambulatory care setting from 2003 to 2011
Narula N.*1, Borges L.2, Steinhart A.H.3, Colombel J.-F.4
1McMaster University, Gastroenterology, Hamilton, Canada 2Brigham and Women's Hospital, Boston, United States 3Mount Sinai Hospital, Toronto, Canada 4Mount Sinai Hospital, Gastroenterology, New York, United States
Prior to the availability of biologic therapies, corticosteroids and narcotics were frequently used in inflammatory bowel disease (IBD) patients due to a paucity of disease modifying therapies. The increased accessibility to effective biologics for IBD over the last decade should be leading to less use of corticosteroids and narcotic medications.
Data from the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) were used to examine visits of patients with IBD. Trends in corticosteroid and narcotic prescriptions were explored, and predictors of use were assessed using survey-weighted chi-square tests.
From 2003 to 2011, a total of 1119 patients with IBD had visits recorded in the NAMCS and NHAMCS databases. Although biologic prescriptions significantly increased from 3.3% in 2003–05 to 15.9% in 2009–11 (p=0.004), there was no significant decrease in corticosteroid or narcotic prescriptions during this same time frame (Figure 1).
Patients with IBD were less likely to receive narcotics (odds ratio (OR) = 0.38) when seeing a medical specialist compared to primary care physicians or surgeons.
Despite the availability of more effective biologic therapies, prescriptions for corticosteroids and narcotics did not decline in IBD patients visiting U.S. ambulatory clinics and emergency departments from 2003 to 2011.