Opioid use and prescription in emergency departments visits in Taiwan: a nationwide population-based retrospective study

Abstract

The emergency departments (EDs) prescribed opioids in acute pains and had thus been one of its major sources. We aimed to describe the features of EDs opioid use in Taiwan from 2008 to 2018. A retrospective cross-sectional study was conducted through Taiwan’s National Health Insurance Database. The patients having an index EDs visit from 2008 to 2018 were identified who had been administered or prescribed opioid at discharge. The general trend and the trend for each type of opioid prescribed from EDs in Taiwan were explored along with the diagnosis resulting in opioid prescriptions in EDs. The opioid prescription from EDs in the study period accounted for 9.72% to 11.97%of the total opioid prescriptions in Taiwan. The rate (prescriptions per 104 persons) of opioids prescription in EDs peaked from 282.64/104 in 2008 to 330.24/104 in 2015, and declined to 286.47/104 in 2018. The pethidine prescription rate had downward trend from 123.05/104 in 2008 to 23.69/104 in 2018 in EDs. Morphine was the most administered opioid in 2009 (121.11/104) which increased to 180.99/104 in 2018. The reasons for opioid prescriptions in EDs were the abdominal pain followed by chest pain, respiratory discomfort and cancer-related pain. It was noted that EDs prescriptions of morphine, codeine and fentanyl had an increasing trend in Taiwan between 2008 to 2018, while pethidine had a declining trend. Morphine was the most used and prescribed opioid in EDs, and the leading cause for opioid usage was abdominal pains.