Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis.
Support Care Cancer
; 30(12): 9781-9791, 2022 Dec.
Article
em En
| MEDLINE
| ID: mdl-36396793
ABSTRACT
PURPOSE:
Cancer is a major reason for concurrent prescription of opioids with other sedating medications-particularly benzodiazepines and gabapentinoids-yet population-based assessments of the extent and predictors of concurrent prescribing among clinically and demographically diverse patients with cancer are lacking.METHODS:
We conducted a retrospective cohort study of patients with non-metastatic cancer using North Carolina cancer registry data linked with Medicare and private insurance claims (2013-2016). We used modified Poisson regression to assess associations of patient characteristic with adjusted relative risk (aRR) of new concurrent prescribing of opioids with benzodiazepines or gabapentinoids after diagnosis.RESULTS:
Overall, 15% of patients were concurrently prescribed opioids with benzodiazepines or gabapentinoids. Characteristics independently associated with an increased risk of concurrent prescribing included cancer type (e.g., aRR cervical vs. colorectal cancer 1.55, 95% CI 1.12-2.14); prior use of opioids (aRR 2.43, 95% CI2.21-2.67), benzodiazepines (aRR 4.08, 95% CI 3.72-4.48), or gabapentinoids (3.82, 95% CI 3.31-4.39), and premorbid mental health conditions, including substance use disorder (aRR 1.27, 95% CI 1.05-1.54). Black and Hispanic patients were less likely to experience concurrent prescribing (aRR, Black vs. White 0.35, 95% CI 0.15-0.83; aRR, Hispanic vs. White 0.75, 95% CI 0.66-0.85).CONCLUSION:
Approximately 1 in 7 patients with cancer was concurrently prescribed opioids with other sedating medications. Associations between patient characteristics and risk of concurrent prescribing highlight predictors of concurrent prescribing and suggest a rationale for systematic assessment of substance use history at diagnosis. Future research could explore inequitable pain and symptom management and investigate risk of adverse medication-related events.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Analgésicos Opioides
/
Neoplasias
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Support Care Cancer
Assunto da revista:
NEOPLASIAS
/
SERVICOS DE SAUDE
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos