Impact of hepatitis C treatment on pain intensity, prescription opioid use and arthritis.
Aged
Analgesics, Opioid
/ administration & dosage
Antiviral Agents
/ adverse effects
Arthralgia
/ complications
Arthritis, Rheumatoid
/ complications
Drug Prescriptions
Electronic Health Records
Female
Hepatitis C
/ complications
Humans
Male
Middle Aged
Pain Measurement
Retrospective Studies
Severity of Illness Index
Time Factors
Treatment Outcome
Veterans Health
arthritis
direct-acting anti-virals
hepatitis C
opioid
pain
Journal
International journal of rheumatic diseases
ISSN: 1756-185X
Titre abrégé: Int J Rheum Dis
Pays: England
ID NLM: 101474930
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
19
07
2018
revised:
10
11
2018
accepted:
17
12
2018
pubmed:
8
2
2019
medline:
4
9
2019
entrez:
8
2
2019
Statut:
ppublish
Résumé
To assess the impact of direct acting anti-viral (DAA) therapy for hepatitis C virus (HCV) infection on changes in pain intensity and prescription opioid use among Veterans. We conducted a retrospective cohort study of Veterans with HCV who were seen in a rheumatology clinic at least once while receiving DAA therapy between January 1, 2010 and December 31st 2016. Demographic characteristics, HCV status, HCV treatment characteristics, numeric rating scale (NRS) pain scores and opioid prescription data were extracted from the electronic medical record. Pain scores were averaged over 6 months prior to HCV treatment and 6 months after completion of treatment. Prescription opioid dose was converted to a morphine equivalent daily dose (MEDD) and averaged across the two 6-month intervals. Generalized estimating equations were used to model the change in average pain and MEDD from pre- to post-HCV treatment. Effect size was assessed using Cohen's d. A total of 121 Veterans, 91% male with average age of 59 were included. Average pre-treatment pain was 4.4 (SD 2.4). The average reduction in pain scores was 0.6 points (P = 0.02, Cohen's d = 0.22) after treatment. Among 67 patients prescribed chronic opioid therapy at baseline, average pre-treatment MEDD was 52.4 mg (SD = 62.5 mg) and post-DAA treatment average MEDD was 49.5 mg (SD = 69.3 mg), representing a decrease by 2.9 mg (P < 0.01, Cohen's d = 0.14). Opioid dose reduction was seen in 43/67 patients and 12 patients discontinued opioids entirely. Among US Veterans, subjective pain scores had modest improvement and opioid prescriptions were mildly reduced following treatment with DAA.
Identifiants
pubmed: 30729702
doi: 10.1111/1756-185X.13479
pmc: PMC7863794
mid: NIHMS1011863
doi:
Substances chimiques
Analgesics, Opioid
0
Antiviral Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
592-598Subventions
Organisme : NIAMS NIH HHS
ID : K23 AR064372
Pays : United States
Informations de copyright
© 2019 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
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