scholarly journals Chronic opioid use and complication risks in women with endometriosis: a cohort study in US administrative claims

2021 ◽  
Author(s):  
Stephanie E. Chiuve ◽  
Ryan D. Kilpatrick ◽  
Mark D. Hornstein ◽  
Natalia Petruski‐Ivleva ◽  
Lani R. Wegrzyn ◽  
...  
Keyword(s):  
Cohort Study ◽  
Administrative Claims ◽  
Opioid Use ◽  
Chronic Opioid Use

scholarly journals Patterns and predictors of chronic opioid use in older adults: A retrospective cohort study

PLoS ONE ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. e0210341 ◽  
Author(s):  
GYeon Oh ◽  
Erin L. Abner ◽  
David W. Fardo ◽  
Patricia R. Freeman ◽  
Daniela C. Moga
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Opioid Use ◽  
Chronic Opioid Use

scholarly journals Chronic use of tramadol after acute pain episode: cohort study

BMJ ◽  
2019 ◽  
pp. l1849 ◽  
Author(s):  
Cornelius A Thiels ◽  
Elizabeth B Habermann ◽  
W Michael Hooten ◽  
Molly M Jeffery
Keyword(s):  
Acute Pain ◽  
Elective Surgery ◽  
Risk Difference ◽  
Administrative Claims ◽  
Opioid Use ◽  
Short Acting ◽  
Adjusted Risk ◽  
Post Surgery ◽  
Percentage Points ◽  
Chronic Opioid Use

AbstractObjectiveTo determine the risk of prolonged opioid use in patients receiving tramadol compared with other short acting opioids.DesignObservational study of administrative claims data.SettingUnited States commercial and Medicare Advantage insurance claims (OptumLabs Data Warehouse) January 1, 2009 through June 30, 2018.ParticipantsOpioid-naive patients undergoing elective surgery.Main outcome measureRisk of persistent opioid use after discharge for patients treated with tramadol alone compared with other short acting opioids, using three commonly used definitions of prolonged opioid use from the literature: additional opioid use (defined as at least one opioid fill 90-180 days after surgery); persistent opioid use (any span of opioid use starting in the 180 days after surgery and lasting ≥90 days); and CONSORT definition (an opioid use episode starting in the 180 days after surgery that spans ≥90 days and includes either ≥10 opioid fills or ≥120 days’ supply of opioids).ResultsOf 444 764 patients who met the inclusion criteria, 357 884 filled a discharge prescription for one or more opioids associated with one of 20 included operations. The most commonly prescribed post-surgery opioid was hydrocodone (53.0% of those filling a single opioid), followed by short acting oxycodone (37.5%) and tramadol (4.0%). The unadjusted risk of prolonged opioid use after surgery was 7.1% (n=31 431) with additional opioid use, 1.0% (n=4457) with persistent opioid use, and 0.5% (n=2027) meeting the CONSORT definition. Receipt of tramadol alone was associated with a 6% increase in the risk of additional opioid use relative to people receiving other short acting opioids (incidence rate ratio 95% confidence interval 1.00 to 1.13; risk difference 0.5 percentage points; P=0.049), 47% increase in the adjusted risk of persistent opioid use (1.25 to 1.69; 0.5 percentage points; P<0.001), and 41% increase in the adjusted risk of a CONSORT chronic opioid use episode (1.08 to 1.75; 0.2 percentage points; P=0.013).ConclusionsPeople receiving tramadol alone after surgery had similar to somewhat higher risks of prolonged opioid use compared with those receiving other short acting opioids. Federal governing bodies should consider reclassifying tramadol, and providers should use as much caution when prescribing tramadol in the setting of acute pain as for other short acting opioids.

scholarly journals Opioid Use in Patients with Ankylosing Spondylitis Is Common in the United States: Outcomes of a Retrospective Cohort Study

2019 ◽  
Vol 46 (11) ◽  
pp. 1450-1457 ◽  
Author(s):  
Victor S. Sloan ◽  
Anna Sheahan ◽  
Jeffrey L. Stark ◽  
Robert Y. Suruki
Keyword(s):  
Cohort Study ◽  
Ankylosing Spondylitis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Index Date ◽  
International Classification Of Diseases ◽  
The United States ◽  
Research Database ◽  
Opioid Use ◽  
Chronic Opioid Use

Objective.To assess the prevalence of chronic opioid use in patients with ankylosing spondylitis (AS), and to compare the characteristics of patients with and without chronic opioid use.Methods.This was a retrospective cohort study of patients with AS identified in the Truven Health MarketScan Research database between January 1, 2012, and March 31, 2017. Commercial and Medicaid claims data were examined using both specific (720.0 and M45.x) and broader (720.x and M45.x) International Classification of Diseases (ICD) coding definitions. Patients were aged ≥ 18 years on the date of first qualifying ICD code occurrence (the index date). Demographics and clinical characteristics were assessed in the 12-month period preceding the index date. The 12-month followup period was used to assess prevalence and characteristics of chronic opioid use.Results.Chronic opioid use was common among patients with commercial claims (23.5% of ICD 720.0 patients; 27.3% of ICD 720.x patients), and especially those with Medicaid claims (57.1% and 76.7%, respectively). The proportion of patients with claims for anti–tumor necrosis factor therapies during followup was often low, and for Medicaid patients was lower among those with chronic opioid use (29.6% of ICD 720.0 patients; 2.3% of ICD 720.x patients) than those without (47.1% and 7.1%, respectively). Among chronic opioid users in all cohorts, the cumulative supply of opioids was typically high (≥ 270 days in the followup period); most opioids prescribed were Schedule II.Conclusion.Patients with AS receive opioids with disturbing frequency. The infrequent prescription of recommended therapies to these patients reflects a need to optimize treatment further through education of patients and healthcare professionals alike.

scholarly journals Risk factors for new chronic opioid use after hip fracture surgery: a Danish nationwide cohort study from 2005 to 2016 using the Danish multidisciplinary hip fracture registry

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e039238
Author(s):  
Nina McKinnon Edwards ◽  
Claus Varnum ◽  
Søren Overgaard ◽  
Lone Nikolajsen ◽  
Christian Fynbo Christiansen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hip Fracture ◽  
Postoperative Treatment ◽  
Renal Diseases ◽  
First Year ◽  
Opioid Use ◽  
Hip Fracture Surgery ◽  
Chronic Opioid Use ◽  
Fracture Surgery

ObjectiveTo examine the risk factors for new chronic opioid use in elderly patients who underwent hip fracture surgery.DesignProspective population-based cohort study.Setting and participantsUsing Danish nationwide health registries, we identified all opioid non-user patients aged ≥65 years who had undergone hip fracture surgery from 2005 to 2016 and were alive within the first year following surgery.Main outcome measuresNew chronic opioid use defined by the dispensing of at least two prescription opioids within two of the last three quarters during the first year following surgery.ResultsWe identified 37 202 opioid non-user patients who underwent hip fracture surgery. Of these, 5497 (15%) developed new chronic opioid user within 1 year of surgery. Risk factors for new chronic opioid use were Body Mass Index (BMI) of <18.5 (adjusted OR (aOR) 1.22, 95% CI 1.09 to 1.36), BMI of 25.0–29.9 (aOR 1.12, 95% CI 1.04 to 1.21) and BMI of ≥30 (aOR 1.57, 95% CI 1.40 to 1.76) with BMI 18.6–24.9 as reference, a pertrochanteric/subtrochanteric fracture (aOR 1.27, 95% CI 1.20 to 1.34) with femoral neck fracture as reference, preoperative use (vs no-use) of non-steroidal anti-inflammatory drug (aOR 1.68, 95% CI 1.55 to 1.83), selective serotonin reuptake inhibitor (aOR 1.42, 95% CI 1.32 to 1.53), antidepressants (aOR 1.36, 95% CI 1.24 to 1.49), antipsychotics (aOR 1.21, 95% CI 1.07 to 1.35), corticosteroids (aOR 1.54, 95% CI 1.35 to 1.76), statins (aOR 1.09, 95% CI 1.02 to 1.18), antibiotics (aOR 1.32, 95% CI 1.22 to 1.42), antiosteoporosis drugs (aOR 1.33, 95% CI 1.19 to 1.49) and anticoagulatives (aOR 1.24, 95% CI 1.17 to 1.32). Presence of cardiovascular comorbidities, diabetes, gastrointestinal diseases, dementia, chronic obstructive pulmonary disease or renal diseases was further identified as a risk factor.ConclusionIn this large nationwide cohort study, we identified several risk factors associated with new chronic opioid use after hip fracture surgery among patients who were alive within the first year following surgery. Although not all factors are modifiable preoperative, this will allow clinicians to appropriately counsel patients preoperatively and tailor postoperative treatment.

Risk of chronic opioid use in older persons with pre-existing anxiety

2020 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Anna K. Moffat, PhD ◽  
Nicole L. Pratt, PhD ◽  
Mhairi Kerr, MSc ◽  
Lisa M. Kalisch Ellett, PhD ◽  
Elizabeth E. Roughead, PhD
Keyword(s):  
Older People ◽  
Proportional Hazards ◽  
Significant Proportion ◽  
Administrative Claims ◽  
Opioid Use ◽  
Prior Surgery ◽  
History Of ◽  
Chronic Opioid Use ◽  
Older Populations ◽  
Chronic Use

Objective: Work that has shown a relationship between anxiety and chronic opioid use has not focused on older people specifically, despite the additional risks in older populations. This study aimed to understand whether anxiety prior to opioid initiation increased the likelihood of chronic opioid use over time in persons aged 60 years or older.Design: Administrative claims data were used to calculate time between initiation of opioids and a first chronic episode of opioid use. Patients were classified as having a history of anxiety if they were dispensed medicines in the anxiolytics class or had a hospitalization event for anxiety prior to treatment with an opioid. Proportional hazards models were used to compare the likelihood of experiencing a chronic episode of opioid use between those with and without a history of anxiety.Results: The cohort was 15,000 persons, of which, 5,076 (34 percent) had history of anxiety. Those with anxiety prior to their first opioid dispensing were 30 percent more likely to have an episode of chronic use after adjustment for age, gender, number of comorbidities, and prior surgery (HR = 1.30, 95% CI = 1.16-1.47). The risk of a chronic episode in patients who had surgery prior to initiation of an opioid was 60 percent greater in those with anxiety compared to no anxiety (HR = 1.60, 95% CI = 1.21-2.11) and 24 percent greater in those with anxiety but no prior surgery (HR = 1.24, 95% CI = 1.08-1.42).Conclusions: A significant proportion of older people will have a chronic episode of opioid use. This risk is increased where a history of anxiety is present.

scholarly journals Risk factors for persistent and new chronic opioid use in patients undergoing total hip arthroplasty: a retrospective cohort study

BMJ Open ◽  
2016 ◽  
Vol 6 (4) ◽  
pp. e010664 ◽  
Author(s):  
Maria C S Inacio ◽  
Craig Hansen ◽  
Nicole L Pratt ◽  
Stephen E Graves ◽  
Elizabeth E Roughead
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Opioid Use ◽  
Total Hip ◽  
Chronic Opioid Use

Chronic opioid use and clinical outcomes in lung transplant recipients: A single-center cohort study

2018 ◽  
Vol 12 (9) ◽  
pp. 2446-2453 ◽  
Author(s):  
David Drees ◽  
Dmitry Tumin ◽  
Rebecca Miller ◽  
Stephen Kirkby ◽  
Tarun Bhalla ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Single Center ◽  
Opioid Use ◽  
Chronic Opioid Use ◽  
Lung Transplant Recipients
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