Pain management clinics (PMCs) play a central role in managing complex pain conditions, yet nationwide data on opioid prescription trends in this specialized setting remain limited. This study examined opioid prescribing patterns in Taiwanese PMCs from 2008 to 2018. This nationwide retrospective population-based study used data from the Taiwan National Health Insurance Research Database. Adult patients aged 18 years or older who received at least 1 opioid prescription during outpatient PMC visits between 2008 and 2018 were included. Opioid medications were identified using Anatomical Therapeutic Chemical classification codes. Prescription trends by opioid type, associated diagnoses, hospital level, and age group were analyzed using linear regression. A total of 2,37,766 opioid prescriptions were issued across PMCs during the study period. Annual prescription counts fluctuated without a significant overall trend ( P = .49), and prescriptions per patient remained stable (range: 2.92–3.49; P = .87), indicating that volume changes reflected patient number fluctuations rather than escalating prescribing intensity. Morphine was the most prescribed opioid, while pethidine declined markedly; oxycodone, introduced in 2016, surged to 4024 prescriptions by 2018. The leading indications were chronic pancreatitis (23.98%), oral cancer (15.26%), and neuropathic pain (12.35%), with non-cancer pain comprising 65.8% to 71.3% of prescriptions annually. Prescription rates increased significantly in patients aged 51 to 64 years ( P = .04), and medical centers showed a significant upward trend in prescribing per 100 beds ( P < .001). Opioid prescribing in Taiwanese PMCs was stable overall, with a shift from traditional agents toward newer high-potency opioids. The predominance of non-cancer pain indications and the centralization of prescribing within medical centers highlight the need for targeted stewardship policies and post-market surveillance of newly introduced opioids.
Ng et al. (Fri,) studied this question.