Prevalence and associated factors of opioid-related disorders among patients with chronic pain: a single-center retrospective study in a Chinese tertiary hospital

BACKGROUND: Opioid-related disorders (ORD) among patients with chronic pain represents a significant clinical challenge, yet surveillance data within Chinese healthcare settings remain limited. This study explored the feasibility of utilizing hospital information system (HIS) data to quantify indicators of ORD and analyze associated factors in a tertiary care setting. METHODS: A retrospective study was conducted at Nanjing Drum Tower Hospital. Patients with chronic pain prescribed opioids for ≥ 90 days between 2022 and 2023 were included. Indicators of ORD were defined by the presence of an ICD-10 diagnosis of opioid use disorder (OUD), documented subjective symptoms, or prescription overlap accounting for ≥ 25% of the total treatment duration. Multivariate logistic regression was performed to identify independent associated factors for ORD. RESULTS: Among 751 eligible patients, 126 (16.8%) met the criteria for ORD. Multivariate analysis revealed that a history of cancer (OR: 2.47; 95% CI: 1.26-4.86), obtaining prescriptions from multiple departments (OR: 1.41; 95% CI: 1.16-1.71), and the initial use of sustained-release (SR) formulations (OR: 1.97; 95% CI: 1.18-3.29) were significant independent associated factors. Furthermore, every 50 mg increment in the maximum daily morphine milligram equivalent (MME) was significantly associated with an increased factor of ORD (OR: 1.27; 95% CI: 1.18-1.37). CONCLUSION: Iatrogenic ORD is a notable concern in this population, driven by specific prescribing patterns such as the early initiation of SR formulations and multi-source prescribing. These findings highlight the urgency of implementing active HIS-based surveillance algorithms and establishing regional inter-hospital data sharing to mitigate the risks of long-term dependency and OUD.