Global patterns of prescription pain medication usage in disorders of gut–brain interactions

• Published in: Neurogastroenterology and motility 2023-01, Vol.35 (1), p.e14457-n/a
• Main Authors: Luo, Yuying, Camey, Suzi A., Bangdiwala, Shrikant I., Palsson, Olafur S., Sperber, Ami D., Keefer, Laurie A.
• Format: Article
• Language: English
• Subjects: Anxiety Disorders; Brain; Diagnosis; disorders of gut‐brain interaction; Geographical variations; Humans; Original; Pain; Pain - drug therapy; prescription pain medications; Prescriptions; Sociodemographics; Surveys and Questionnaires
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.14457

Background Forty percent of individuals globally meet Rome IV criteria for a disorder of gut–brain interaction (DGBI). The global burden of pain across these disorders has not been characterized. Methods Our study included 54,127 respondents from the 26 Internet survey countries. Prescription pain medication usage was selected as the proxy for pain. The associations between prescription pain medications and the environmental, sociodemographic, psychosocial, and DGBI diagnosis variables were investigated using the multivariate generalized robust Poisson regression model. Key Results Respondents with DGBI used prescription pain medications at higher rates than those without a DGBI diagnosis with pooled prevalence rate of 14.8% (95% confidence interval [CI], 14.4–15.3%), varying by country from 6.8% to 25.7%. The pooled prevalence ratio of prescription pain medication usage in respondents with and without DGBI was 2.2 (95% CI: 2.1–2.4). Factors associated with higher prevalence of pain medication usage among respondents with a DGBI diagnosis included living in a small community, increased anxiety, depression or somatization, increased stress concern or embarrassment about bowel functioning and having more than one anatomic DGBI diagnosis. Conclusion 14.8% of patients globally with at least one diagnosis of DGBI were on prescription pain medications with wide geographic variation, about twice as many as their counterparts without a diagnosis of DGBI. Environmental, sociodemographic, and individual factors may influence clinicians to consider personalized, multimodal approaches to address pain in patients with DGBI. 14.8% of respondents globally who have ≥1 DGBI diagnosis were on prescription pain medications, ~2× as high as respondents without a DBGI diagnosis. Wide geographic variation, but pain medication prescription patterns in DGBI are influenced by overall national prescribing behaviors.