Jaewhan Kim1, Norman Waitzman2, Nathan Richards3, Ted Adams4. 1. Department of Physical Therapy, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA. jaewhan.kim@utah.edu. 2. Department of Economics, University of Utah, 260 Central Campus Dr #4100, Salt Lake City, UT, 84112, USA. 3. Intermountain Health Care, 5300 South State Street, Murray, UT, 84107, USA. 4. Division of Epidemiology, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA.
Abstract
BACKGROUND: Significant and sustained weight loss resulting from bariatric surgery have demonstrated clinical reduction in severe obesity-related pain. Subsequentially, post-surgical pain reduction may reduce pain medication use. However, clear evidence regarding use of prescribed pain medications before and after bariatric surgery is absent. METHODS: Linking two state-wide databases, patients who underwent bariatric surgery between July 1, 2013 and December 31, 2015 were identified. Proportion tests were used to compare percent of patients with pain medication prescriptions 1 year before and 1 year after bariatric surgery. Logistic regression was used to identify baseline factors that were associated with pain medication use 1-year following surgery. RESULTS: A total of 3535 bariatric surgical patients aged 18-64 years at surgery were identified. Of these patients, 1339 patients met the following study criteria: covered by private insurance; known pre-surgical BMI; and continuous enrollment with health plan(s) from 12-month pre-surgery to 13-month post-surgery. While comparison of average number of overall pain medication prescriptions before and after surgery did not change, from 3.46 to 3.32 prescriptions (p value = 0.26), opioid prescription use increased from 1.62 vs. 2.05 (p value < 0.01). Patients prescribed more types of pain medications before surgery were more likely to have prescribed pain medications after surgery. Patients prescribed benzodiazepines at baseline had higher odds being prescribed post-surgery corticosteroids (OR = 1.89, p value < 0.01), muscle relaxants (OR = 2.18, p value < 0.01), and opioids (OR = 3.06, p value = < 0.01) compared to patients without pre-surgery--prescribed benzodiazepine. CONCLUSION: While comparison of average number of overall pain medication prescriptions before and after bariatric surgery did not decrease, opioid prescription increased post-surgery. Further studies are needed to examine whether post-surgery opioids are prescribed in lieu of or in tandem with other pain medication prescriptions.
BACKGROUND: Significant and sustained weight loss resulting from bariatric surgery have demonstrated clinical reduction in severe obesity-related pain. Subsequentially, post-surgical pain reduction may reduce pain medication use. However, clear evidence regarding use of prescribed pain medications before and after bariatric surgery is absent. METHODS: Linking two state-wide databases, patients who underwent bariatric surgery between July 1, 2013 and December 31, 2015 were identified. Proportion tests were used to compare percent of patients with pain medication prescriptions 1 year before and 1 year after bariatric surgery. Logistic regression was used to identify baseline factors that were associated with pain medication use 1-year following surgery. RESULTS: A total of 3535 bariatric surgical patients aged 18-64 years at surgery were identified. Of these patients, 1339 patients met the following study criteria: covered by private insurance; known pre-surgical BMI; and continuous enrollment with health plan(s) from 12-month pre-surgery to 13-month post-surgery. While comparison of average number of overall pain medication prescriptions before and after surgery did not change, from 3.46 to 3.32 prescriptions (p value = 0.26), opioid prescription use increased from 1.62 vs. 2.05 (p value < 0.01). Patients prescribed more types of pain medications before surgery were more likely to have prescribed pain medications after surgery. Patients prescribed benzodiazepines at baseline had higher odds being prescribed post-surgery corticosteroids (OR = 1.89, p value < 0.01), muscle relaxants (OR = 2.18, p value < 0.01), and opioids (OR = 3.06, p value = < 0.01) compared to patients without pre-surgery--prescribed benzodiazepine. CONCLUSION: While comparison of average number of overall pain medication prescriptions before and after bariatric surgery did not decrease, opioid prescription increased post-surgery. Further studies are needed to examine whether post-surgery opioids are prescribed in lieu of or in tandem with other pain medication prescriptions.
Authors: Tuğrul Çakır; Mehmet Tahir Oruç; Arif Aslaner; Fatih Duygun; Erdem Can Yardımcı; Burhan Mayir; Nurullah Bülbüller Journal: Int J Clin Exp Med Date: 2015-02-15
Authors: Rafia S Rasu; Kiengkham Vouthy; Ashley N Crowl; Anne E Stegeman; Bithia Fikru; Walter Agbor Bawa; Maureen E Knell Journal: J Manag Care Spec Pharm Date: 2014-09