Rebecca Arden Harris1, Henry R Kranzler2, Kyong-Mi Chang3, Chyke A Doubeni4, Robert Gross5. 1. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: Harris@pennmedicine.upenn.edu. 2. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; VISN 4 Mental Illness Research, Education and Clinical Center, The Corporal Michael Crescenz VA Medical Center, United States. 3. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; The Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, United States. 4. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States. 5. Department of Medicine, Infectious Diseases, Department of Epidemiology, Biostatistics, Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Abstract
BACKGROUND: Hydrocodone and oxycodone are the Schedule II opioids most often prescribed in primary care. Notwithstanding the dangers of prescription opioid use, the likelihood of long-term use with either drug is presently unknown. METHODS: Using a retrospective cohort design and data from a commerical healthcare claims repository, we compared the likelihood of long-term use of hydrocodone and oxycodone in primary care patients presenting with acute back pain. Treatment was categorized as long-term if the prescription dates spanned ≥90 days from initial prescription to the run-out date of the last prescription, and included ≥120 days' supply or ≥10 fills. Instrumental variable methods and probit regression were used to model the effect of drug choice on long-term use, estimate the average treatment effect, and correct for confounding by indication. RESULTS: A total of 3,983 patients who were prescribed only hydrocodone or only oxycodone were followed for 270 days in 2016. Long-term opioid use was observed in 320 patients (8%). Controlling for potential confounders including morphine milligram equivalents and dosage, an estimated 12% (95 CI, 10%-14%) treated with hydrocodone transitioned to long-term use vs. 2% (95 CI, 1%-3%) on oxycodone. Among patients who received more than one prescription (n = 1,866), an estimated 23% (95 CI, 19%-26%) treated with hydrocodone transitioned to long-term use vs. 5% (95 CI, 3%-7%) on oxycodone. The difference between drugs was supported in sensitivity and subgroup analyses. Sample selection bias was not detected. CONCLUSIONS: Long-term use was substantially greater for patients treated with hydrocodone than oxycodone, despite equianalgesia.
BACKGROUND: Hydrocodone and oxycodone are the Schedule II opioids most often prescribed in primary care. Notwithstanding the dangers of prescription opioid use, the likelihood of long-term use with either drug is presently unknown. METHODS: Using a retrospective cohort design and data from a commerical healthcare claims repository, we compared the likelihood of long-term use of hydrocodone and oxycodone in primary care patients presenting with acute back pain. Treatment was categorized as long-term if the prescription dates spanned ≥90 days from initial prescription to the run-out date of the last prescription, and included ≥120 days' supply or ≥10 fills. Instrumental variable methods and probit regression were used to model the effect of drug choice on long-term use, estimate the average treatment effect, and correct for confounding by indication. RESULTS: A total of 3,983 patients who were prescribed only hydrocodone or only oxycodone were followed for 270 days in 2016. Long-term opioid use was observed in 320 patients (8%). Controlling for potential confounders including morphine milligram equivalents and dosage, an estimated 12% (95 CI, 10%-14%) treated with hydrocodone transitioned to long-term use vs. 2% (95 CI, 1%-3%) on oxycodone. Among patients who received more than one prescription (n = 1,866), an estimated 23% (95 CI, 19%-26%) treated with hydrocodone transitioned to long-term use vs. 5% (95 CI, 3%-7%) on oxycodone. The difference between drugs was supported in sensitivity and subgroup analyses. Sample selection bias was not detected. CONCLUSIONS: Long-term use was substantially greater for patients treated with hydrocodone than oxycodone, despite equianalgesia.
Authors: M Kit Delgado; Yanlan Huang; Zachary Meisel; Sean Hennessy; Michael Yokell; Daniel Polsky; Jeanmarie Perrone Journal: Ann Emerg Med Date: 2018-07-24 Impact factor: 5.721
Authors: Jennifer Brennan Braden; Mark D Sullivan; G Thomas Ray; Kathleen Saunders; Joseph Merrill; Michael J Silverberg; Carolyn M Rutter; Constance Weisner; Caleb Banta-Green; Cynthia Campbell; Michael Von Korff Journal: Gen Hosp Psychiatry Date: 2009-08-27 Impact factor: 3.238
Authors: Constance M Weisner; Cynthia I Campbell; Thomas G Ray; Kathleen Saunders; Joseph O Merrill; Caleb Banta-Green; Mark D Sullivan; Michael J Silverberg; Jennifer R Mertens; Denise Boudreau; Michael Von Korff Journal: Pain Date: 2009-07-05 Impact factor: 6.961
Authors: Antoine Koehl; Hongli Hu; Shoji Maeda; Yan Zhang; Qianhui Qu; Joseph M Paggi; Naomi R Latorraca; Daniel Hilger; Roger Dawson; Hugues Matile; Gebhard F X Schertler; Sebastien Granier; William I Weis; Ron O Dror; Aashish Manglik; Georgios Skiniotis; Brian K Kobilka Journal: Nature Date: 2018-06-13 Impact factor: 49.962
Authors: Yu Fu; Irene Lorrai; Barry Zorman; Daniele Mercatelli; Chase Shankula; Jorge Marquez Gaytan; Celine Lefebvre; Giordano de Guglielmo; Hyunjae Ryan Kim; Pavel Sumazin; Federico M Giorgi; Vez Repunte-Canonigo; Pietro Paolo Sanna Journal: Viruses Date: 2022-03-24 Impact factor: 5.818