scholarly journals Patterns of initial opioid prescription and its association with short-term and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027203 ◽  
Author(s):  
Che Suraya Zin ◽  
Nor Ilyani Nazar ◽  
Norny Syafinaz Abdul Rahman ◽  
Wan Rohaidah Ahmad ◽  
Nurul Sahida Rani ◽  
...  
Keyword(s):  
Cohort Study ◽  
Outcome Measures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Opioid Use ◽  
Short Term ◽  
Opioid Prescription ◽  
Long Acting ◽  
Opioid Users

ObjectiveThis study examined opioid prescription initiation patterns and their association with short-term and long-term opioid use among opioid-naïve patients.DesignThis study was designed as a retrospective cohort study.Setting and participantsIn this study, we analysed the prescription databases of tertiary hospitals in Malaysia. This study included patients aged ≥18 years with at least one opioid prescription (buprenorphine, morphine, oxycodone, fentanyl, dihydrocodeine or tramadol) between 1 January 2011 and 31 December 2016. These patients had no opioid prescriptions in the 365 days prior, and were followed up for 365 days after the initial opioid prescription.Main outcome measuresThe main outcome measures were the number of short-term (<90 days) and long-term opioid users (≥90 days), initial opioid prescription period and daily dose.ResultsThere were 33 752 opioid-naïve patients who received opioid prescriptions (n=43 432 prescriptions) during the study period. Of these, 29 824 (88.36%) were short-term opioid users and 3928 (11.64%) were long-term opioid users. The majority of these short-term (99.09%) and long-term users (96.18%) received an initial daily opioid dose of <50 mg/day with a short-acting opioid formulation. Short-term opioid users were predominantly prescribed opioids for 3–7 days (59.06%) by the emergency department (ED, 60.56%), while long-term opioid users were primarily prescribed opioids for ≥7 days (91.85%) by non-ED hospital departments (91.8%). The adjusted model showed that the following were associated with long-term opioid use: increasing opioid daily doses, prescription period ≥7 days and long-acting opioids initiated by non-EDs.ConclusionsThe majority of opioid-naïve patients in tertiary hospital settings in Malaysia were prescribed opioids for short-term use. The progression to long-term use among opioid-naïve patients was attributed to the prescription of higher opioid doses for a longer duration as well as long-acting opioids initiated by non-ED hospital departments.

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

2015 ◽  
Vol 22 (3) ◽  
pp. 211-215 ◽  
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

Pulmonary thromboendarterectomy is a curative resolution for chronic thromboembolic pulmonary hypertension associated with antiphospholipid syndrome: a retrospective cohort study

Lupus ◽  
2018 ◽  
Vol 27 (14) ◽  
pp. 2206-2214 ◽  
Author(s):  
C Li ◽  
J Zhao ◽  
S Liu ◽  
W Song ◽  
J Zhu ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cohort Study ◽  
Cardiac Function ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Short Term ◽  
Pulmonary Thromboendarterectomy ◽  
Thromboembolic Pulmonary Hypertension

Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and life-threatening condition with poor prognosis in patients with antiphospholipid syndrome (APS). Pulmonary thromboendarterectomy (PTE) is the optimal surgical option for CTEPH. Objectives This retrospective cohort study aimed to evaluate the efficacy and risk of PTE in patients with APS-associated CTEPH. Methods Consecutive patients with APS-associated CTEPH diagnosed between January 2012 and September 2017 at Peking Union Medical College Hospital were retrospectively evaluated. Demographics, clinical manifestations, antiphospholipid antibody (aPL) profiles, and pulmonary arterial hypertension–targeted medications were collected. Deterioration of cardiac function and death were chosen as the endpoints, in order to assess the effect of PTE on short-term and long-term prognoses (evaluated by the change of cardiac function after treatment and cardiac deterioration or death in the follow-up, respectively). Results A total of 20 patients with APS-associated CTEPH were enrolled, and eight patients underwent PTE. Chi-square test ( p = 0.01) and Kaplan–Meier curves (log rank test, p = 0.04) showed that there were statistically significant differences in both short-term and long-term prognoses between patients with and without PTE. Conclusion These results provide strong evidence that PTE is a curative resolution in patients with APS-associated CTEPH. Following a full specialized and multidisciplinary risk-benefit evaluation to limit the risk of thrombosis or bleeding and to manage possible thrombocytopenia, PTE is at least a temporal curative resolution for CTEPH complicated with APS.

scholarly journals Long-acting Opioid Use and the Risk of Serious Infections: A Retrospective Cohort Study

2018 ◽  
Vol 68 (11) ◽  
pp. 1862-1869 ◽  
Author(s):  
Andrew D Wiese ◽  
Marie R Griffin ◽  
William Schaffner ◽  
C Michael Stein ◽  
Robert A Greevy ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Opioid Use ◽  
Serious Infections ◽  
Long Acting

scholarly journals Long-term opioid use after inpatient surgery – A retrospective cohort study

2018 ◽  
Vol 187 ◽  
pp. 61-65 ◽  
Author(s):  
Karsten Bartels ◽  
Ana Fernandez-Bustamante ◽  
Shannon K. McWilliams ◽  
Christian J. Hopfer ◽  
Susan K. Mikulich-Gilbertson
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Opioid Use

Long-Term Outcomes of Short-Term Statin Use in Healthy Adults: A Retrospective Cohort Study

Drug Safety ◽  
2016 ◽  
Vol 39 (6) ◽  
pp. 543-559 ◽  
Author(s):  
Ishak A. Mansi ◽  
Jenny English ◽  
Song Zhang ◽  
Eric M. Mortensen ◽  
Ethan A. Halm
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Healthy Adults ◽  
Long Term Outcomes ◽  
Short Term ◽  
Statin Use

Retrospective cohort study of healthcare utilization and opioid use following radiofrequency ablation for chronic axial spine pain in Ontario, Canada

2019 ◽  
Vol 44 (3) ◽  
pp. 398-405 ◽  
Author(s):  
Eldon Loh ◽  
Jennifer N Reid ◽  
Fatimah Alibrahim ◽  
Blayne Welk
Keyword(s):  
Cohort Study ◽  
Radiofrequency Ablation ◽  
Healthcare Utilization ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Drug Benefit ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Physician Visits ◽  
Spine Pain

Background and objectivesRadiofrequency ablation (RFA) is a common treatment modality for chronic axial spine pain. Controversy exists over its effectiveness, and outcomes in a real-world setting have not been evaluated despite increasing use of RFA. This study examined changes in healthcare utilization and opioid use after RFA in Ontario, Canada.MethodsThis retrospective cohort study was conducted in Ontario using administrative data. Ontario residents receiving their initial RFA between 1 January 2009 and 31 March 2015 were included. Physician visits, spinal injections, and opioid dosing/prescriptions in the 12-month periods before and after RFA were compared.ResultsThe study included 4653 patients. The number of RFA procedures significantly increased from 2009 to 2014 (22.5 cases/1 000 000 person-years to 82.5 cases/1 000 000 person-years). 4465 patients had at least one physician visit pre-RFA; there was a significant 23.89% reduction in physician visits post-RFA (pre-RFA: 29 616 visits; post-RFA: 22 542 visits). All reviewed specialties demonstrated a decrease in physician visits post-RF except neurosurgery. 3445 (85.70%) fewer spinal interventions for axial pain (medial/lateral branch blocks, facet/sacroiliac injections) were performed post-RFA. Significantly fewer epidurals were also performed post-RFA. 198 of 1007 patients (19.66%) on the Ontario Drug Benefit who received opioids pre-RFA did not require a postprocedure opioid prescription. Mean opioid dosing was unchanged post-RFA.ConclusionsHealthcare utilization was significantly reduced in the 12 months following RFA, and some patients eliminated opioid use. Selection criteria for RFA are not standardized in Ontario, and appropriate use guidelines for spine interventions may improve outcomes and reduce unnecessary procedures.

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