Impact of expanded strong opioid availability on opioid prescription patterns in patients with cancer: A population-wide cohort study in Taiwan

ObjectivesSex as a biological variable affects response to opioids. However, few reports describe the prevalence of specific adverse reactions to commonly prescribed opioids in men and women separately. A large cohort was used to investigate sex differences in type and occurrence of adverse reactions associated with use of codeine, tramadol, oxycodone and hydrocodone.DesignRetrospective cohort study.SettingParticipants in the Right Drug, Right Dose, Right Time (RIGHT) Study.ParticipantsThe medical records of 8457 participants in the RIGHT Study who received an opioid prescription between 1 January 2004 and 31 December 2017 were reviewed 61% women, 94% white, median age (Q1–Q3)=58 (47–66).Primary and secondary outcome measuresAdverse reactions including gastrointestinal, skin, psychiatric and nervous system issues were collected from the allergy section of each patient’s medical record. Sex differences in the risk of adverse reactions due to prescribed opioids were modelled using logistic regression adjusted for age, body mass index, race and ethnicity.ResultsFrom 8457 participants (of which 449 (5.3%) reported adverse reactions), more women (6.5%) than men (3.4%) reported adverse reactions to at least one opioid (OR (95% CI)=2.3 (1.8 to 2.8), p<0.001). Women were more likely to report adverse reactions to tramadol (OR (95% CI)=2.8 (1.8 to 4.4), p<0.001) and oxycodone (OR (95% CI)=2.2 (1.7 to 2.9), p<0.001). Women were more likely to report gastrointestinal (OR (95% CI)=3.1 (2.3 to 4.3), p<0.001), skin (OR (95% CI)=2.1 (1.4 to 3.3), p=0.001) and nervous system issues (OR (95% CI)=2.3 (1.3 to 4.2), p=0.004).ConclusionsThese findings support the importance of sex as a biological variable to be factored into pain management studies.

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Patients with cancer and atrial fibrillation treated with doacs: A prospective cohort study

International Journal of Cardiology ◽

10.1016/j.ijcard.2018.07.138 ◽

2018 ◽

Vol 269 ◽

pp. 152-157 ◽

Cited By ~ 16

Author(s):

Maria Cristina Vedovati ◽

Michela Giustozzi ◽

Paolo Verdecchia ◽

Lucia Pierpaoli ◽

Serenella Conti ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Patients With Cancer

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Early opioid prescription and risk of long-term opioid use among US workers with back and shoulder injuries: a retrospective cohort study

Injury Prevention ◽

10.1136/injuryprev-2015-041630 ◽

2015 ◽

Vol 22 (3) ◽

pp. 211-215 ◽

Cited By ~ 4

Author(s):

Sara E Heins ◽

Dorianne R Feldman ◽

David Bodycombe ◽

Stephen T Wegener ◽

Renan C Castillo

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Shoulder Injuries ◽

Opioid Use ◽

Opioid Prescription

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Long-term distress in older patients with cancer: a longitudinal cohort study

BJGP Open ◽

10.3399/bjgpopen19x101658 ◽

2019 ◽

Vol 3 (3) ◽

pp. bjgpopen19X101658 ◽

Cited By ~ 1

Author(s):

Stephanie Dauphin ◽

Leontien Jansen ◽

Tine De Burghgraeve ◽

Laura Deckx ◽

Frank Buntinx ◽

...

Keyword(s):

Cohort Study ◽

Cancer Diagnosis ◽

Older Patients ◽

Contact Point ◽

Longitudinal Cohort Study ◽

Aged Patients ◽

Major Life ◽

Longitudinal Cohort ◽

Patients With Cancer

BackgroundReceiving a cancer diagnosis can be a major life event which causes distress even years after primary treatment.AimTo examine the prevalence of distress in older patients with cancer (OPCs) up until 5 years post-diagnosis, and identify predictors present at time of diagnosis. Results are compared with reference groups of middle-aged patients with cancer (MPCs) and older patients without a cancer diagnosis (OPs).Design & settingOPCs, MPCs, and OPs participated in a longitudinal cohort study in Belgium and the Netherlands by filling in questionnaires at designated time points from 2010–2019.MethodData from 541 patients were analysed using multivariable logistic regression analyses.ResultsAt baseline, 40% of OPCs, 37% of MPCs, and 17% of OPs reported distress. After 5 years, 35% of OPCs, 23% of MPCs, and 25% of OPs reported distress. No significant predictors for long-term distress in OPCs and OPs were found. For MPCs, it was found that baseline distress (odds ratio [OR] 2.94; 95% confidence intervals [CI] = 1.40 to 6.19) and baseline fatigue (OR 4.71; 95% CI = 1.81 to 12.31) predicted long-term distress.ConclusionDistress is an important problem for people with cancer, with peaks at different moments after diagnosis. Feelings of distress are present shortly after diagnosis but they decrease quickly for the majority of patients. In the long term, however, OPCs in particular appear to be most at risk for distress. This warrants extra attention from primary healthcare professionals, such as GPs who are often patients’ first medical contact point. More research into risk factors occurring later in an illness trajectory might shed more light on predictors for development of long-term distress.

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