Patterns of prescription opioid use before total hip and knee replacement among US Medicare enrollees.
Osteoarthritis Cartilage
; 27(10): 1445-1453, 2019 10.
Article
em En
| MEDLINE
| ID: mdl-31251985
ABSTRACT
OBJECTIVE:
To examine patterns of prescription opioid use before total joint replacement (TJR) and factors associated with continuous use of opioids before TJR.DESIGN:
We conducted an observational cohort study among Medicare enrollees aged ≥65 years who underwent TJR between 2010 and 2014. Preoperative opioid use was defined as having any opioid prescription in the 12-month period before TJR. Patients who had an opioid prescription every month for a 12-month period were defined as continuous users. We examined patients' demographics, pain-related conditions, medication use, other comorbidities, healthcare utilization and their association with use of opioids before TJR.RESULTS:
A total of 473,781 patients underwent TJR,155,516 THR and 318,265 TKR. Among the total cohort, 60.2% patients had any use of opioids and of those, 12.4% used opioids at least once a month continuously over the 12-month baseline period. Correlates of continuous opioid use included African American race (OR = 2.14, 95% confidence intervals (CI) = 2.01-2.28, compared to White patients), history of drug abuse (OR = 5.18, 95% CI = 3.95-6.79) and back pain (OR = 2.32, 95% CI = 2.24-2.39).CONCLUSIONS:
In this large cohort of patients undergoing TJR, over 60% ever used opioids and 12.4% of them continuously used opioids in the 12-month prior to surgery. Utilization of opioids became more frequent and high-dosed near the surgery. History of drug abuse, back pain, and African American race were strongly associated with continuous use of opioids preoperatively. Further research is needed to determine short-term and long-term risks of preoperative use of opioids in TJR patients and to optimize pre- and post-TJR pain management of patients with arthritis.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Prescrições de Medicamentos
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Cuidados Pré-Operatórios
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Osteoartrite do Quadril
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Artralgia
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Artroplastia de Quadril
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Artroplastia do Joelho
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Osteoartrite do Joelho
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Analgésicos Opioides
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article