Chronic opioid use after laryngeal cancer treatment.


Journal

Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541

Informations de publication

Date de publication:
04 2021
Historique:
revised: 14 11 2020
received: 01 02 2020
accepted: 17 12 2020
pubmed: 29 12 2020
medline: 1 7 2021
entrez: 28 12 2020
Statut: ppublish

Résumé

Survivors of head and neck cancer may be at increased risk for chronic opioid use and questions remain about risk factors. Retrospective study of patients with laryngeal cancer prescribed opioids utilizing the Truven Health Marketscan database. Patients had laryngeal cancer, underwent treatment, filled an opioid prescription, and were enrolled in this private insurance plan 1 year prior to and after treatment. In this study, 7484 patients were included; 17.2% developed chronic opioid use, defined as consecutive opioid fills at least 90 days after treatment cessation. Early opioid use (OR = 3.607, 95% CI [3.125-4.163]), tobacco use (OR = 1.28, 95% CI [1.117-1.467]), median morphine milligram equivalent (MME; OR = 1.001, 95% CI [1.000-1.0001]), and radiation alone (OR = 1.435, 95% CI [1.199-1.717]) were predictive of chronic opioid use. Nearly one in five patients prescribed opioids during treatment developed chronic use. Providers should discuss the risk of chronic opioid use, set expectations for opioid weaning, and consider adjunct pain regimens to develop effective pain management strategies.

Sections du résumé

BACKGROUND
Survivors of head and neck cancer may be at increased risk for chronic opioid use and questions remain about risk factors.
METHODS
Retrospective study of patients with laryngeal cancer prescribed opioids utilizing the Truven Health Marketscan database. Patients had laryngeal cancer, underwent treatment, filled an opioid prescription, and were enrolled in this private insurance plan 1 year prior to and after treatment.
RESULTS
In this study, 7484 patients were included; 17.2% developed chronic opioid use, defined as consecutive opioid fills at least 90 days after treatment cessation. Early opioid use (OR = 3.607, 95% CI [3.125-4.163]), tobacco use (OR = 1.28, 95% CI [1.117-1.467]), median morphine milligram equivalent (MME; OR = 1.001, 95% CI [1.000-1.0001]), and radiation alone (OR = 1.435, 95% CI [1.199-1.717]) were predictive of chronic opioid use.
CONCLUSIONS
Nearly one in five patients prescribed opioids during treatment developed chronic use. Providers should discuss the risk of chronic opioid use, set expectations for opioid weaning, and consider adjunct pain regimens to develop effective pain management strategies.

Identifiants

pubmed: 33368718
doi: 10.1002/hed.26591
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1242-1251

Subventions

Organisme : NIH National Center for Advancing Translational Sciences
ID : UL1TR001998

Informations de copyright

© 2020 Wiley Periodicals LLC.

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Auteurs

Nicole Starr (N)

Department of Otolaryngology, University of Kentucky Medical Center, Lexington, Kentucky, USA.

Douglas R Oyler (DR)

College of Pharmacy, University of Kentucky, Lexington, Kentucky, USA.

Aric Schadler (A)

College of Pharmacy, University of Kentucky, Lexington, Kentucky, USA.

Rony K Aouad (RK)

Department of Otolaryngology, University of Kentucky Medical Center, Lexington, Kentucky, USA.

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