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Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient Cohort.
Wentz, Anna E; Wang, Ralph C; Marshall, Brandon D L; Shireman, Theresa I; Liu, Tao; Merchant, Roland C.
Afiliação
  • Wentz AE; Brown University School of Public Health, Department of Epidemiology, Providence, Rhode Island.
  • Wang RC; University of California, San Francisco, Department of Emergency Medicine, San Francisco, California.
  • Marshall BDL; Brown University School of Public Health, Department of Epidemiology, Providence, Rhode Island.
  • Shireman TI; Brown University School of Public Health, Health Services Policy & Practice, Providence, Rhode Island.
  • Liu T; Brown University School of Public Health, Data & Statistics Core of Brown Alcohol Research Center on HIV (ARCH), Providence, Rhode Island.
  • Merchant RC; Harvard Medical School, Brigham and Women's Hospital Department of Emergency Medicine, Boston, Massachusetts.
West J Emerg Med ; 23(6): 864-871, 2022 Oct 23.
Article em En | MEDLINE | ID: mdl-36409937
ABSTRACT

INTRODUCTION:

Urolithiasis causes severe acute pain and is commonly treated with opioid analgesics in the emergency department (ED). We examined opioid analgesic use after episodes of acute pain.

METHODS:

Using data from a longitudinal trial of ED patients with urolithiasis, we constructed multivariable models to estimate the adjusted probability of opioid analgesic use 3, 7, 30, and 90 days after ED discharge. We used multiple imputation to account for missing data and weighting to account for the propensity to be prescribed an opioid analgesic at ED discharge. We used weighted multivariable regression to compare longitudinal opioid analgesic use for those prescribed vs not prescribed an opioid analgesic at discharge, stratified by reported pain at ED discharge.

RESULTS:

Among 892 adult ED patients with urolithiasis, 79% were prescribed an opioid analgesic at ED discharge. Regardless of reporting pain at ED discharge, those who were prescribed an opioid analgesic were significantly more likely to report using it one, three, and seven days after the visit in weighted multivariable analysis. Among those who were not prescribed an opioid analgesic, an estimated 21% (not reporting pain at ED discharge) and 30% (reporting pain at discharge) reported opioid analgesic use at day three. Among those prescribed an opioid analgesic, 49% (no pain at discharge) and 52% (with pain at discharge) reported using an opioid analgesic at day three.

CONCLUSION:

Urolithiasis patients who received an opioid analgesic at ED discharge were more likely to continue using an opioid analgesic than those who did not receive a prescription at the initial visit, despite the time-limited nature of urolithiasis.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Urolitíase / Dor Aguda / Transtornos Relacionados ao Uso de Opioides Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Urolitíase / Dor Aguda / Transtornos Relacionados ao Uso de Opioides Idioma: En Ano de publicação: 2022 Tipo de documento: Article