Sammie T James1, Ambrish A Pandit2, Bruno Machado2, Nalin Payakachat2, Mohamed Kamel3,4. 1. University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA. stjames@uams.edu. 2. University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA. 3. Ain Shams University, Cairo, Egypt. 4. University of Cincinnati Medical Center, Cincinnati, USA.
Abstract
PURPOSE: This study evaluated possible predictors of long-term opioid usage among patients with ureteric stones who received ureteroscopy (URS) or shockwave lithotripsy (SWL). We also assessed opioid usage characteristics of URS and SWL recipients. MATERIALS AND METHODS: This retrospective study used IQVIA PharMetrics® Plus for Academics administrative claims database from years 2006-2020 to identify patients with a diagnosis of kidney or ureteral stones who were treated with either SWL or URS. We performed unadjusted bivariate analyses to compare opioid use characteristics of URS and SWL recipients, and performed logistic regression to determine demographic and clinical factors associated with becoming a long-term opioid user. RESULTS: The study population consisted of opioid naive individuals having a diagnosis of a kidney stone who underwent URS (N = 9407) or SWL (N = 4894). About 6.7% (N = 964) of study subjects were long-term opioid users. Unadjusted bivariate associations showed that compared to non-long-term opioid users, long-term opioid users had significantly greater total days' supply, total morphine milliequivalents (MME) supplied, and claims per month. A similar trend was observed for URS (vs. SWL) recipients. However, compared to SWL recipients, URS recipients had 14.3% (1.2-25.6%; p = 0.034) lower odds of becoming long-term users. Total days' supply (OR: 1.041 (95% CI 1.030-1.052; p < 0.001) and total MME supplied (OR 1.001 (95% CI 1.000-1.001; p < 0.001) were significantly associated with long-term usage. CONCLUSION: Higher total days' supply and total MME supplied as well as SWL were identified as risk factors for becoming long-term opioid users.
PURPOSE: This study evaluated possible predictors of long-term opioid usage among patients with ureteric stones who received ureteroscopy (URS) or shockwave lithotripsy (SWL). We also assessed opioid usage characteristics of URS and SWL recipients. MATERIALS AND METHODS: This retrospective study used IQVIA PharMetrics® Plus for Academics administrative claims database from years 2006-2020 to identify patients with a diagnosis of kidney or ureteral stones who were treated with either SWL or URS. We performed unadjusted bivariate analyses to compare opioid use characteristics of URS and SWL recipients, and performed logistic regression to determine demographic and clinical factors associated with becoming a long-term opioid user. RESULTS: The study population consisted of opioid naive individuals having a diagnosis of a kidney stone who underwent URS (N = 9407) or SWL (N = 4894). About 6.7% (N = 964) of study subjects were long-term opioid users. Unadjusted bivariate associations showed that compared to non-long-term opioid users, long-term opioid users had significantly greater total days' supply, total morphine milliequivalents (MME) supplied, and claims per month. A similar trend was observed for URS (vs. SWL) recipients. However, compared to SWL recipients, URS recipients had 14.3% (1.2-25.6%; p = 0.034) lower odds of becoming long-term users. Total days' supply (OR: 1.041 (95% CI 1.030-1.052; p < 0.001) and total MME supplied (OR 1.001 (95% CI 1.000-1.001; p < 0.001) were significantly associated with long-term usage. CONCLUSION: Higher total days' supply and total MME supplied as well as SWL were identified as risk factors for becoming long-term opioid users.
Authors: Shahid Shafi; Ashley W Collinsworth; Laurel A Copeland; Gerald O Ogola; Taoran Qiu; Maria Kouznetsova; I-Chia Liao; Natalie Mears; An T Pham; George J Wan; Andrew L Masica Journal: JAMA Surg Date: 2018-08-01 Impact factor: 14.766
Authors: Lorri A Lee; Robert A Caplan; Linda S Stephens; Karen L Posner; Gregory W Terman; Terri Voepel-Lewis; Karen B Domino Journal: Anesthesiology Date: 2015-03 Impact factor: 7.892
Authors: Michael S Leapman; Eric DeRycke; Melissa Skanderson; William C Becker; Danil V Makarov; Cary P Gross; Mary Driscoll; Piruz Motamedinia; Harini Bathulapalli; Kristin Mattocks; Cynthia A Brandt; Sally Haskell; Lori A Bastian Journal: Pain Med Date: 2018-09-01 Impact factor: 3.750