Analgesic Prescribing in Medically Complex Adult Outpatients Aged ≥40 Years: A Hierarchical Analysis of Comorbidity-Associated Patterns

Background/Objectives: Selecting appropriate analgesic therapy in patients with multimorbidity is increasingly challenging because clinicians must balance pain management against comorbidities, polypharmacy, and medication-related risks. However, evidence describing how analgesic prescribing patterns vary across patients with different multimorbidity profiles in routine outpatient practice remains limited. This retrospective cross-sectional study examined associations between multimorbidity and prescribing patterns across paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), and opioids, and identified clinical characteristics associated with different hierarchical analgesic exposure groups among adults aged ≥40 years in Saudi Arabia.

Methods

Electronic health record data were analyzed for adults aged ≥40 years attending multiple clinics in the Eastern Region of Saudi Arabia between January 2020 and December 2021. Analgesic exposure at the index outpatient visit was classified using a hierarchical framework into mutually exclusive paracetamol-only, NSAID-priority, opioid-priority, or non-use groups. Multinomial logistic regression was performed to identify clinical characteristics associated with assignment to the hierarchical analgesic exposure groups.