869 Opioid Utilization in Pediatric Burn Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S273-S274
Author(s):  
Niti Shahi ◽  
Maxene Meier ◽  
Ryan Phillips ◽  
Gabrielle Shirek ◽  
Ashley Banks ◽  
...  
Keyword(s):  
Parent Education ◽  
Multimodal Therapy ◽  
Medication Use ◽  
Pain Medication ◽  
Categorical Variables ◽  
Burn Patients ◽  
Opioid Use ◽  
Over The Counter ◽  
Pain Medications ◽  
Opioid Administration

Abstract Introduction Childhood burns are extremely common and distressing for children and their parents. Pain is the most common complaint and often thought to be undertreated, disrupting care and increasing the risk of post-traumatic stress disorder. There is limited literature on the role of opioids and multimodal therapy in the treatment of burns in pediatric patients. We sought to evaluate the current use of multimodal therapy as well as the use, storage, and disposal of opioids in this patient population. Methods We prospectively surveyed parents of pediatric burn patients (0–18 years old) who presented to the burn clinic within two weeks of burn injury. Parents were surveyed regarding over-the-counter pain medication use and opioid medication use, storage, and disposal in the treatment of their child. Medians and interquartile ranges were used to describe continuous variables and frequencies and percentages were used for categorical variables. Results A total of 92 parents of burn-injured children were surveyed at a single institution in the outpatient burn clinic. The median age of burn-injured children was 3.1 years old, and 50% of patients were male. The majority had a TBSA of 1%. The hand was the most frequently burned location (45.7%). Acetaminophen (58.7%) and ibuprofen (69.6%) were the most common treatments for both constant and breakthrough pain. Approximately 28% (26/92) of patients were prescribed opioids, of which 18.5% (17/92) filled their prescription. Only 29% of patients (5/17) consumed their entire prescription, and a median of 3 doses of opioids remained for those who did not finish the entire prescription. Parents most commonly decided to give their children opioid pain medications because “my child is in severe pain” or “I give my child pain medications as scheduled (written on prescription).” Approximately 40% (7/17) of patients who filled opioid prescriptions stored them in a locked area, and only 35.3% (6/17) were educated on how to dispose of excess opioid pain medication. Conclusions Presently, multimodal therapy with over-the-counter pain medications is used to treat the majority of pediatric burns. This study demonstrates an increased need for education on opioid administration, storage, and disposal for parents of burn-injured children. Applicability of Research to Practice We aimed to evaluate what current trends in opioid use are in pediatric burn patients and areas for improvement in parent education for over-the-counter pain medication use, opioid use, opioid storage, and disposal. From the study, we were able to glean that the majority of patients are successfully managed with over-the-counter pain medications. However, parents and patients managed with opioids need additional education on appropriate administration of opioid pain medications, safe locked storage of opioids, and opioid disposal. This demonstrates an area for quality improvement inpatient and outpatient.

Pain Management for Pediatric Burns in the Outpatient Setting: A Changing Paradigm?

2020 ◽  
Vol 41 (4) ◽  
pp. 814-819
Author(s):  
Niti Shahi ◽  
Maxene Meier ◽  
Ryan Phillips ◽  
Gabrielle Shirek ◽  
Adam Goldsmith ◽  
...  
Keyword(s):  
Pain Control ◽  
Multimodal Therapy ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Medication Use ◽  
Pain Medication ◽  
Outpatient Setting ◽  
Burn Injuries ◽  
Opioid Prescription ◽  
Over The Counter

Abstract Childhood burns are common and distressing for children and their parents. Pain is the most common complaint and often thought to be undertreated, which can negatively influence the child’s care and increase the risk of posttraumatic stress disorder. There is limited literature on the role of opioids and multimodal therapy in the treatment of pediatric outpatient burns. We sought to evaluate the current use of opioids (including the use of multimodal therapies), storage, and disposal of opioids in this patient population. Parents of burn-injured children 8 months to 18 years old, who were seen in an outpatient setting within 2 weeks of their burn injury, were queried from April to December 2019 regarding their child’s pain control, opioid medication use, over-the-counter pain medication use, opioid storage, and disposal. A total of 142 parents of burn-injured children and their parents were surveyed. The median age of the burn-injured children was 2.7 years old and the majority (54.2%; 77/142) were male. The mean total body surface area (TBSA) was 1.8% and half sustained burn injuries to one or both hands. The most frequently used regimens for constant and/or breakthrough pain control were acetaminophen (62.7%) and nonsteroidal anti-inflammatory drugs (NSAIDs; 68.3%). Less than one fifth (26/142;18%) of patients were prescribed opioids and 88% filled their prescription. The median number of doses of opioids prescribed was eight doses, with a median of four doses of opioids unused. Only three patients used all of their prescribed opioids and no patient ≥12 years old used their entire prescription. Burns greater than 3% TBSA, irrespective of burn injury location, were associated with opioid prescription (P = .003). Approximately 40% (10/26) of parents who filled their child’s opioid prescription stored the opioid in a locked area. Fewer than one third (7/26) of patients were educated on how to dispose of excess opioid pain medication. Overall, most pediatric outpatient burn injuries can be successfully managed with over-the-counter medications. Providers, who care for burn-injured children ≤ 12 years old with burns that cover ≥3% TBSA in the outpatient setting, should consider no more than four opioid doses for initial pain control. This guideline, coupled with family and provider-centered education on multimodal therapy at the time of initial presentation and safe use of opioids, are important first steps to minimizing the use of opioids in the management of small area burns in children.

scholarly journals OPIOID USE IN ADOLESCENTS FOLLOWING HIP AND KNEE ARTHROSCOPY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0008
Author(s):  
S. Clifton Willimon ◽  
Michael Busch ◽  
Melissa Christino ◽  
Belinda Schaafsma ◽  
Crystal Perkins
Keyword(s):  
Risk Factors ◽  
Pain Control ◽  
Knee Arthroscopy ◽  
Medication Use ◽  
Pain Medication ◽  
Opioid Use ◽  
Pain Scores ◽  
Pain Medications ◽  
Post Operative Pain ◽  
Opioid Medications

Background: The use and misuse of opioid medications has been declared an epidemic and public health emergency by the Centers for Disease Control. From 1999 – 2016, there was a 5-fold increase in overdose deaths secondary to opioids1. Pain control is an important component of post-operative care following orthopaedic surgery and opioid medications are commonly prescribed. The purpose of this study is to describe the average opioid use among adolescents following hip and knee arthroscopy. Methods: All patients less than 21 years of age undergoing ACL reconstruction, simple knee arthroscopy (plica and fat pad debridement, loose body removal, partial meniscectomy, or chondroplasty), and hip arthroscopy for femoroacetabular impingement were prospectively enrolled in this IRB-approved study. This is an interim report for an ongoing study with anticipated completion of enrollment in December 2018. All patients received hydrocodone-acetaminophen 5-325 mg for post-operative pain control. The number of pills prescribed was based on physician preference and was not dictated by the study. Patients and their families completed a medication logbook to track all doses of pain medication and associated pain scores. Risk factors for hydrocodone use following surgery were analyzed, including age, sex, race, pre-operative use of narcotic pain medications, surgical factors, and post-operative VAS pain scores. Results: A total of 65 patients were enrolled and completed the medication logbook, including 37 females and 28 males with a mean age of 15.6 years (range 7 – 20 years). Patients received a prescription for an average of 28 hydrocodone tablets (range 10 – 60) and 64 patients (98%) filled the prescription. The mean number and range of hydrocodone tablets consumed and remaining at the end of treatment and VAS pain scores at the time the patients consumed the pain medication are listed in the figure below. Forty-two patients (65%) reported one or more side effects from the hydrocodone, with the most common being drowsiness and constipation. There were no risk factors that predicted increased use of hydrocodone following ACL reconstruction or knee arthroscopy. Female sex and higher post-operative VAS pain scores predicted greater use of hydrocodone in patients following hip arthroscopy. Conclusions: Opioid medication use in adolescents following hip and knee arthroscopy is significantly less than the quantity of tablets prescribed, with 60% of the medication we prescribed remaining unused in the post-operative period. We recommend orthopaedic surgeons responsibly prescribe pain medications using evidence-based data or the results of their own experience monitoring medication consumption. Additionally, and important in the setting of the “opioid epidemic,” physicians must counsel patients and families of post-operative pain expectations and appropriate medication use. This study will provide the framework for the future development of educational resources regarding prescribing and use of pain medications for healthcare providers, patients, and caregivers. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2017 [Table: see text]

scholarly journals Psychotropic and pain medication use in individuals with traumatic brain injury—a Swedish total population cohort study of 240 000 persons

2021 ◽  
Vol 92 (5) ◽  
pp. 519-527
Author(s):  
Yasmina Molero ◽  
David James Sharp ◽  
Brian Matthew D'Onofrio ◽  
Henrik Larsson ◽  
Seena Fazel
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Total Population ◽  
Medication Use ◽  
Population Based ◽  
Pain Medication ◽  
Short Term ◽  
Pain Medications ◽  
Before And After

ObjectiveTo examine psychotropic and pain medication use in a population-based cohort of individuals with traumatic brain injury (TBI), and compare them with controls from similar backgrounds.MethodsWe assessed Swedish nationwide registers to include all individuals diagnosed with incident TBI between 2006 and 2012 in hospitals or specialist outpatient care. Full siblings never diagnosed with TBI acted as controls. We examined dispensed prescriptions for psychotropic and pain medications for the 12 months before and after the TBI.ResultsWe identified 239 425 individuals with incident TBI, and 199 658 unaffected sibling controls. In the TBI cohort, 36.6% had collected at least one prescription for a psychotropic or pain medication in the 12 months before the TBI. In the 12 months after, medication use increased to 45.0%, an absolute rate increase of 8.4% (p<0.001). The largest post-TBI increases were found for opioids (from 16.3% to 21.6%, p<0.001), and non-opioid pain medications (from 20.3% to 26.6%, p<0.001). The majority of prescriptions were short-term; 20.6% of those prescribed opioids and 37.3% of those with benzodiazepines collected prescriptions for more than 6 months. Increased odds of any psychotropic or pain medication were associated with individuals before (OR: 1.62, 95% CI: 1.59 to 1.65), and after the TBI (OR: 2.30, 95% CI: 2.26 to 2.34) as compared with sibling controls, and ORs were consistently increased for all medication classes.ConclusionHigh rates of psychotropic and pain medications after a TBI suggest that medical follow-up should be routine and review medication use.

scholarly journals Comparison of Two Different Analgesic Prescription Strategies and Healthcare Systems: Slovenia vs. the Netherlands

2021 ◽  
Vol 2 ◽  
Author(s):  
Ajda Bedene ◽  
Anita Strmljan ◽  
Eveline L. A. van Dorp ◽  
Mitja Udovič ◽  
Willem M. Lijfering ◽  
...  
Keyword(s):  
The Netherlands ◽  
Medication Use ◽  
Pain Medication ◽  
Opioid Use ◽  
Pharmacy Claims ◽  
Frequent Use ◽  
Prescribing Practice ◽  
Inflammatory Drugs ◽  
Strong Opioids ◽  
Prescription Databases

Background: Prescribing practice of pain medication is changing in the Netherlands; opioids are used more often instead of nonsteroidal anti-inflammatory drugs (NSAIDs), therefore we aimed to compare the use of pain medication with Slovenia which has stringent prescribing rules for strong opioids.Methods: We conducted a cohort study into national prescription databases of the Netherlands and Slovenia covering pharmacy claims between January 1, 2013 and December 31, 2019. In the analysis about 17 million Dutch and 2 million Slovenian residents were included.Findings: The use of opioids and NSAIDs was higher in Slovenia than in the Netherlands. More frequent use of opioids in Slovenia could be almost entirely explained by weak opioids (about 6% of the population), whereas they were prescribed 50% less frequently in the Netherlands. The opioid use has increased by about 20% in the Netherlands (4.85 and 6.00% of the population in 2013 and 2018, respectively), and the majority of this increase could be explained by strong opioids (4.05% in 2018), specifically, by oxycodone whose use increased by more than 2-fold between 2013 and 2019. In comparison, oxycodone was seldomly used in Slovenia (about 0.3% of the population received a prescription in a year).Interpretation: When medication use is controlled by stringent prescribing rules, like for strong opioids in Slovenia, the use is lower as compared to when such rules do not exist.

Oral Opioid Use during Vaginal Delivery Hospitalizations

2019 ◽  
Vol 37 (04) ◽  
pp. 390-397
Author(s):  
Mirella Mourad ◽  
Ruth Landau ◽  
Jason D. Wright ◽  
Zainab Siddiq ◽  
Cassandra R. Duffy ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Management Practices ◽  
Opioid Abuse ◽  
Opioid Use ◽  
Hospital Level ◽  
Short Acting ◽  
Pain Medications ◽  
Opioid Administration ◽  
Opioid Medications

Objective This study aimed to determine the receipt of short-acting opioid medications during vaginal delivery hospitalizations. Study Design The Perspective database was analyzed to evaluate patterns of short-acting oral opioid use during vaginal delivery hospitalizations from January 2006 to March 2015. Unadjusted and adjusted models evaluating the role of demographic and hospital factors were created evaluating use of opioids. Hospital-level rates of opioid use were evaluated. Opioid receipt among women with opioid abuse or dependence was evaluated based on overall hospital rates of opioid use. Results Of 3,785,396 vaginal delivery hospitalizations from 2006 to 2015, 1,720,899 (45.5%) women received an oral opioid for pain relief. Opioid use varied significantly among the 458 hospitals included in the analysis, with one-third of hospitals providing opioids to <38% of patients, one-third to 38 to <59% of patients, and one-third to ≥59% of patients. When hospitals were stratified by overall opioid administration rates, women with opioid abuse or dependence were less likely to be given opioids in hospitals with low overall opioid rates. Discussion The use of opioid pain medications during vaginal delivery hospitalizations varied significantly among hospitals, suggesting that standardization of pain management practices could reduce opioid use.

Differences in pain, symptom burden, and opioid use among cancer pain patients with active versus non-active disease.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20568-e20568
Author(s):  
Karina J Bouffard ◽  
Lakshmi Koyyalagunta ◽  
Salahardin Abdi ◽  
Mike Hernandez ◽  
Diane M. Novy
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Symptom Burden ◽  
Disease Status ◽  
Pain Medication ◽  
Categorical Variables ◽  
Opioid Use ◽  
Poor Appetite ◽  
Pain Patients ◽  
Active Disease

e20568 Background: Many cancer survivors with non-active disease suffer with pain and other symptoms. This study investigated differences in symptoms and opioid use among cancer pain patients with active versus non-active disease. Methods: Data were obtained from 518 consecutive new patients seen at the Pain Management Center of MD Anderson Cancer Center from 01/01/09 to 06/30/09. Measures: Usual pain was rated on the Brief Pain Inventory. The Edmonton Symptom Assessment Scale (ESAS) was used for ratings of fatigue, shortness of breath, poor appetite, depression, anxiety, drowsiness, difficulty thinking clearly and insomnia. Opioid use was calculated in morphine equivalency daily dose (MEDD) milligrams based on the sum of long- and short-acting opioids used per day. Analyses of Data: Independent samples t-tests were used to make comparisons between patients with active versus non-active disease on continuous variables. Chi-square tests were used to make comparisons across disease status on categorical variables. Results: 349 patients had active disease; 169 patients had non-active disease. Patients with active disease received significantly higher MEDD (125.6 ± 158.8 mg) versus patients with non-active disease (74.4 ± 87.0 mg). Patients with active disease reported significantly higher mean scores on fatigue, poor appetite, and drowsiness. Average weekly pain scores were comparable and moderately high for both groups of patients. Other symptoms and clinical characteristics were not significantly different across disease status. Conclusions: Plausible explanations for the higher opioid use and symptom burden among patients with active disease are cancer treatments and disease progression. A higher level of pain medication is often needed to achieve pain management during active treatment or following recent surgery. The finding of higher fatigue, poor appetite, and drowsiness among those with active disease is also consistent with the symptom burden expected from treatment. Although patients with active disease have a greater symptom burden and need for pain medication, there is a need for pain and symptom management among patients in the non-active disease phase of survivorship.

Time Variability of Pain Medication Adherence: An Observational Study (Preprint)

2020 ◽  
Author(s):  
Marcia Shade ◽  
Kyle Rector ◽  
Kevin Kupzyk
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Monitoring System ◽  
Self Efficacy ◽  
Medication Use ◽  
Pain Medication ◽  
Medication Event Monitoring System ◽  
Pain Severity ◽  
Event Monitoring ◽  
Pain Medications

BACKGROUND Pain is difficult to manage in older adults. Pain management in older adults has been recommended to include both nonpharmacologic and pharmacologic strategies. Unfortunately, nonadherence to pain medication is more prevalent than any other chronic disease treatment. Technology-based reminders have some benefit for medication adherence but is biased because behavior has been verified by self-report. OBJECTIVE The purpose of this study was to describe objective medication adherence and latency of medication use in a subsample of older adults that used a voice assistant reminder to take scheduled pain medications. METHODS This observational feasibility study was conducted in the homes of community-dwelling older adults. Of the 15 older adults using voice assistant reminders for pain medications, we randomly selected a subsample of participants to use a medication event monitoring system to observe medication adherence. We collected demographics, self-reported health history, and pain medication name, dose, and dose frequency. Baseline data were collected on pain severity and interference using the Brief Pain Inventory-SF; concern and necessity beliefs about pain medications using the Beliefs About Medicines Questionnaire; self-confidence in managing pain with the PROMIS Self-Efficacy for Managing Symptoms and medication adherence with a Medication Event Monitoring System. RESULTS Participants used pain medications to alleviate pain severity ranging from moderate to severe. Each participant had varying beliefs about pain medicines and self-efficacy in managing pain symptoms. Overall latency was 55 minutes. The absolute latency (before or after reminder) varied among the participants; the shortest average time was 17 minutes and the longest was 4.5 hours. Our results found that 15% of the pain medications were taken within 5 minutes over 60% were taken within 30 minutes. CONCLUSIONS Voice assistant reminders may help cue patients to take medications, but the timing of use may vary. It may be helpful to monitor the absolute timing of scheduled medication use as a part of medication adherence behaviors in older adults especially when frequent dosing is prescribed. CLINICALTRIAL Adherence, Pain Medications, Older Adults, Reminders, mHealth, Voice Assistants

scholarly journals PREVALENCE OF OVER THE COUNTER PAIN MEDICATION USE AMONG HIGH SCHOOL VOLLEYBALL PLAYERS

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0025
Author(s):  
Pamela Lang ◽  
Timothy McGuine ◽  
Lianna Mack ◽  
Kevin Biese ◽  
David Bell ◽  
...  
Keyword(s):  
High School ◽  
Female Athletes ◽  
Healthcare Providers ◽  
Medication Use ◽  
Pain Medication ◽  
Pain Medicine ◽  
Medicine Use ◽  
Over The Counter ◽  
The Past ◽  
Volleyball Players

Background: Volleyball’s popularity among middle and high school girls continues to rise with many athletes playing the sport year-round. While up to 40% of high school basketball players consume analgesics frequently to manage sport related pain, there is limited evidence regarding the prevalence of over the counter (OTC) pain medicine use among high school volleyball players. Hypothesis/Purpose: Identify the prevalence of OTC pain medicine use in high school volleyball players and assess its association with prior injury and sports specialization level. Methods: Female volleyball players from 78 high schools were recruited to enroll in this prospective cohort study during the fall 2018 volleyball season. Baseline data were collected on demographic and volleyball characteristics including volume and type of volleyball participation, sport-related injuries over the previous twelve months, and level of sport specialization. The frequency of OTC pain medication use for pain management not related to menstrual cramps over the previous seven days was also collected. Participants were asked to describe their OTC pain medicine use during practice, matches, or conditioning and the location of pain they were treating. Results: In total, 2,073 female athletes (Age: 15.6 ± 1.1, BMI: 22.4 ± 3.5, Grade: 9-12) enrolled in the study. Sixty-nine percent (n=1425) reported no OTC pain medication use over the past seven days, 16.0% (n=332) reported seldom (one day/week) OTC medication use, 12.6% (n=261) reported sometimes (2-3 days/week) using OTC medications, and 2.7% (n=55) reported frequent (4-5 days/week) OTC medication use. In the same time period, 24.8% (n=513) used OTC medications during practice, 16.0% (n=331) during matches, and 21.4% (n=443) during conditioning. Across practice, matches, and conditioning OTC medications were most frequently used to control headaches (7-13%) and knee pain (4-6%). Highly specialized volleyball players were more likely to frequently use OTC medications (4.5%) compared to low (1.97%) and moderately specialized (2.5%) athletes (p=0.001). Of those reporting no OTC medications use, 16.7% (n=238) had an injury in the last year compared 36.4% (n=20) of athletes who frequently used OTC medications also reporting an injury in the last year (p<0.001). Conclusion: Almost one third of female high school volleyball athletes reported using OTC pain medications in the past week. Those with a history of injury and highly specialized athletes were more likely to use OTC medications. Coaches, athletic trainers, and healthcare providers should be aware of trends in the use of OTC medications among volleyball athletes as its popularity continues to rise.

110 Pain Medication Prescription Patterns and the American Burn Association 2020 Guidelines on the Management of Acute Pain in the Adult Burn Patient

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S74-S74
Author(s):  
Natalia Ziolkowski ◽  
Josephine D’Abbondanza ◽  
Sarah Rehou ◽  
Shahriar Shahrohki
Keyword(s):  
Virtual Reality ◽  
Acute Pain ◽  
Average Length ◽  
Medication Use ◽  
Behavioural Therapy ◽  
Pain Medication ◽  
Medication Prescription ◽  
Pain Medications ◽  
New Guidelines ◽  
Burn Patient

Abstract Introduction In September 2020, the American Burn Association released new pain guidelines following a rigorous literature review and input from experts. These guidelines were last updated 14 years ago and represent a multitude of changes including increased importance for non-opioid pain medication use and non-pharmacologic adjuncts given the current opioid crisis. Specifically, the main recommendations were to use opioid medication sparingly and always with adjuncts; acetaminophen utilized in all patients; NSAID use depending on baseline comorbidities and kidney function; neuropathic pain therapy for those with such pain/refractory to standard therapy; and ketamine for procedural sedation/adjunct for opioid consumption. Further, nonpharmacologic treatments include cognitive-behavioural therapy (‘CBT’), hypnosis, and virtual reality should be considered. The objective of this study is to describe current pain medication prescription habits at one ABA-verified centre and how well they are in compliance with these new guidelines. Methods We conducted phase one of a quality improvement retrospective study of 514 patients admitted to an ABA-verified centre over a two-year period. Data included demographics and pain medication use which was compared against the new ABA American Burn Association 2020 Guidelines on the Management of Acute Pain in the Adult Burn Patient. Pain medication contraindications were defined using UpToDate Drug Information. Statistical analysis was descriptive in nature. Results 422 patients were admitted for acute burns. 65.9% were male with an average age of 46.4 (st dev 17.6,range 15–96). Flame burns were most common(n=209,49.5%) with average TBSA of 11.9%(st dev 16.5,range 0–98%) and 54 inhalation injuries(12.8%) covering an average length of stay of 15.6 days in the burn centre (st dev 16.8,range 1–146 days). A total of 3549 pain medications were prescribed: 1792 opioid(50.5%) and 1757 non-opioid(49.5%). Of those admitted, 93.8% were prescribed opioids, 72.5% NSAIDs, 87.2% acetaminophen, 74.4% nerve pain medications, and 25.3% ketamine. Opioids were not prescribed in 26 patients(6.2%) and only prescribed in 29 patients(6.9%). Regarding adjuncts, 4(0.94%) had documented contraindications to NSAIDs and 3(0.71%) to acetaminophen. No referrals were completed for CBT. Virtual reality and hypnosis are not available at this centre. Conclusions This work represents the first known study examining compliance to the new pain guidelines in an ABA-verified burn centre. There is significant room for improvement for the use of adjuncts specifically NSAIDs and acetaminophen as both were under prescribed. In addition, nonpharmacologic treatments are largely not available or not used and may be an untapped resource for better pain control.

scholarly journals Association Between Male Use of Pain Medication and Fecundability

2020 ◽  
Vol 189 (11) ◽  
pp. 1348-1359
Author(s):  
Amelia K Wesselink ◽  
Kathryn A Bresnick ◽  
Elizabeth E Hatch ◽  
Kenneth J Rothman ◽  
Ellen M Mikkelsen ◽  
...  
Keyword(s):  
Medication Use ◽  
Pain Medication ◽  
Sociodemographic Characteristics ◽  
Low Doses ◽  
Pain Reliever ◽  
Pain Medications ◽  
Human Fertility ◽  
Males And Females ◽  
Monthly Dose

Abstract Administration of pain relievers has been associated with both lower and higher risks of adverse reproductive outcomes in animals. In the sole investigation of male pain-reliever use and human fertility carried out to date, Smarr et al. (Hum Reprod. 2016;31(9):2119–2127) found a 35% reduction in fecundability among males with urinary acetaminophen concentrations in the highest quartile (&gt;73.5 ng/mL) versus the lowest (&lt;5.4 ng/mL). We analyzed data from 1,956 males participating in Pregnancy Study Online, a preconception cohort study of North American couples enrolled between 2013 and 2019. Males and females completed baseline questionnaires on sociodemographic characteristics, lifestyle, medication use, and medical history; females completed bimonthly follow-up questionnaires for up to 12 months. We categorized pain medications by active ingredient (ibuprofen, acetaminophen, naproxen, aspirin) and cumulative monthly dose. We used proportional probabilities models to calculate fecundability ratios and 95% confidence intervals, adjusting for potential confounders. In the 4 weeks before baseline, 51.7% of males used pain medications. Adjusted fecundability ratios were 1.02 for ibuprofen (95% confidence interval (CI): 0.91, 1.13), 0.89 for acetaminophen (95% CI: 0.77, 1.03), 1.07 for naproxen (95% CI: 0.85, 1.35), and 1.05 for aspirin (95% CI: 0.81, 1.35), as compared with nonuse of each medication. In this study, male use of pain medications at low doses was not notably associated with fecundability.

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