National trends in opioid-related hospitalizations among patients with cancer.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 199-199
Author(s):  
Isaac S. Chua ◽  
Richard Leiter ◽  
Kate T. Brizzi ◽  
Charles A. Coey ◽  
Emanuele Mazzola ◽  
...  

199 Background: Cancer patients are routinely prescribed opioids for cancer-related pain. With recent attention to the opioid epidemic, we sought to identify risk factors and to describe the incidence of opioid-related hospitalizations among cancer patients. Methods: Serial cross-sectional study of adult cancer patients with opioid-related hospitalizations using the National Inpatient Sample (NIS) database from January 2006 to December 2014. We identified cancer patients using the International Classification of Diseases, Ninth Revision (ICD-9) codes. We defined opioid-related hospitalizations as ICD-9 codes for heroin poisoning, opioid poisoning, or opioid dependence or abuse in the primary diagnosis field. A logistic regression model identified predictors for opioid-related hospitalizations. We adjusted temporal trends for opioid-related hospitalizations for all-cause hospitalizations among cancer patients. Results: Among 25,443,362 hospitalizations for cancer patients, there were 14,336 opioid-related hospitalizations. Non-heroin opioid poisoning made up 88% of opioid-related hospitalizations. Predictors for opioid-related hospitalizations for cancer patients included drug abuse (OR 9.40, 95% CI 8.28 - 10.66), younger age [age 18 - 29 (OR 4.00, 95% CI 3.10 - 5.17); age 30 - 49 (OR 3.99, 95% CI 3.43 - 4.65)], depression (OR 2.17, 95% CI 1.97 - 2.39), alcohol abuse (OR 1.21, 95% CI 1.03 - 1.41), and year of hospitalization [2009-2011 (OR 1.19; 95% CI 1.07 - 1.32); 2012 - 2014 (OR 1.19; 95% CI, 1.06 - 1.32)]. On average, opioid-related hospitalizations increased by 0.003% per year (p = 0.002). Conclusions: Opioid-related hospitalizations among cancer patients are rare, appear to be increasing over time, and are largely due to non-heroin opioid poisoning. Standardized opioid risk screening based on validated predictors may identify cancer patients with the greatest risk of an opioid-related hospitalization.

Pain Medicine ◽  
2021 ◽  
Author(s):  
Yinan Huang ◽  
Sanika Rege ◽  
Satabdi Chatterjee ◽  
Rajender R Aparasu

Abstract Study Objectives To examine the outpatient opioid prescribing practices and the factors associated with opioid prescriptions in patients with Rheumatoid Arthritis (RA). Design This cross-sectional study used the 2011-2016 National Ambulatory Medical Care Survey. Descriptive weighted analyses were used to examine the trends in opioid prescribing practices for RA. Multivariable logistic regression was used to examine the factors associated with opioid prescriptions among RA visits. Subjects Adult patients with a primary diagnosis of RA based on the International Classification of Diseases Results According to the national surveys, an average of 4.45 (95% Confidence Interval [CI], 2.30-6.60) million office visits were made annually for RA. Approximately 24.28% of these visits involved opioid prescriptions. The RA visits involving opioid prescriptions increased from 1.43 million in 2011-2012 to 3.69 million in 2015-2016 (P < 0.0001). Being in the age group of 50-64 years (odds ratio [OR] = 3.40; 95% CI, 1.29-9.00), being Hispanic or Latino (OR = 2.92, 95% CI, 1.10-7.74), visiting primary physician (OR = 4.67; 95% CI, 1.86-11.75), muscle relaxants (OR = 64.32; 95% CI, 9.71-426.09), acetaminophen (OR = 93.40; 95% CI, 26.19-333.04), antidepressants (OR = 6.10; 95% CI, 2.63-14.14), and glucocorticoids (OR = 3.20; 95% CI, 1.61-6.38) were associated with an increased likelihood of receiving opioid prescriptions in RA. Conclusions One in four adult RA visits resulted in opioid prescriptions, and the opioid visits rate more than doubled during the study period. Several patient and provider factors were associated with the opioid prescribing among RA visits. Understanding these prescribing practices can help to devise strategies for safe opioid prescribing practices in RA.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdul Rahman Jazieh ◽  
Khadega A. Abuelgasim ◽  
Husam I. Ardah ◽  
Mohammad Alkaiyat ◽  
Omar B. Da’ar

Abstract Background The use of complementary and alternative medicine (CAM) is common among cancer patients and it may reflect the individual and societal beliefs on cancer therapy. Our study aimed to evaluate the trends of CAM use among patients with cancer between 2006 and 2018. Methods We included 2 Cohorts of patients with cancer who were recruited for Cohort 1 between 2006 and 2008 and for Cohort 2 between 2016 and 2018. The study is a cross-sectional study obtaining demographic and clinical information and inquiring about the types of CAM used, the reasons to use them and the perceived benefits. We compared the changes in the patterns of CAM use and other variables between the two cohorts. Results A total of 1416 patients were included in the study, with 464 patients in Cohort 1 and 952 patients in Cohort 2. Patients in Cohort 2 used less CAM (78.9%) than Cohort 1 (96.8%). Cohort 1 was more likely to use CAM to treat cancer compared to Cohort 2 (84.4% vs. 73%, respectively, p < 0.0001,); while Cohort 2 used CAM for symptom management such as pain control and improving appetite among others. Disclosure of CAM use did not change significantly over time and remains low (31.6% in Cohort 1 and 35.7% for Cohort 2). However, physicians were more likely to express an opposing opinion against CAM use in Cohort 2 compared to Cohort 1 (48.7% vs. 19.1%, p < 0.001, respectively). Conclusion There is a significant change in CAM use among cancer patients over the decade, which reflects major societal and cultural changes in this population. Further studies and interventions are needed to improve the disclosure to physicians and to improve other aspects of care to these patients.


2020 ◽  
Vol 23 (3) ◽  
pp. 169-177
Author(s):  
Alvinda Apriliatul Jannah ◽  
Anisah Ardiana ◽  
Retno Purwandari

Hope is a crucial issue in patients with cancer. Hope can be increased by providing social support. Social support can be obtained from the nurses caring behavior. This research aimed to analyze the relationship between nurses caring behavior and recovery hope level of cancer patients undergoing chemotherapy program at Baladhika Husada Hospital in Jember. A cross-sectional study was conducted to 112 respondents using the Caring Behavior Inventory (CBI-24) questionnaire and Scale of Hope. The data were analyzed applying the Kendall Tau B (τ) correlation. The results showed that there was a relationship between nurses caring behavior with the level of recovery expectancy of cancer patients undergoing chemotherapy programs at Baladhika Husada Hospital in Jember (p-value <0.001; τ = 0.375). Nurse caring behavior increases patient comfort and makes patients more enthusiastic about undergoing therapy. Patients feel valued and get more information from nurses. Therefore, the patient's recovery hopes can increase. This study concludes that nurses caring behavior can increase the expectation of recovery of cancer patients. Abstrak Harapan adalah hal krusial pada pasien kanker. Harapan dapat ditingkatkan dengan pemberian dukungan sosial yang bisa didapat dari perilaku caring perawat. Tujuan dari penelitian ini adalah untuk menganalisis hubungan perilaku caring perawat dengan tingkat harapan sembuh pasien kanker yang menjalani program kemoterapi di Rumah Sakit Baladhika Husada Jember. Penelitian ini menggunakan metode cross sectional dan 112 responden didapatkan dengan teknik sampel purposive samping. Data didapatkan melalui kuesioner CBI-24 dan kuesioner skala harapan. Analisis pada penelitian ini menggunakan uji korelasi Kendall Tau B (τ). Hasil menunjukkan terdapat hubungan antara perilaku caring perawat dengan tingkat harapan sembuh pasien kanker yang menjalani program kemoterapi di Rumah Sakit Baladhika Husada Jember (p value < 0,001; τ = 0,375). Perilaku caring perawat dapat meningkatkan kenyamanan pasien dan membuat pasien lebih semangat menjalankan terapi yang dijalani. Pasien merasa dinilai dan mendapatkan informasi lebih dari perawat. Maka dari itu, harapan sembuh pasien dapat meningkat. Kesimpulan dari penelitian ini adalah perilaku caring perawat dapat meningkatkan harapan sembuh pasien kanker.  


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1525-1525
Author(s):  
John Panzone ◽  
Christopher Welch ◽  
Ruben Pinkhasov ◽  
Joseph M Jacob ◽  
Oleg Shapiro ◽  
...  

1525 Background: Studies show that cancer patients and survivors are likely to endure financial toxicity long after being diagnosed. Methods: To examine the influence of race on financial toxicity among individuals with a history of cancer, a US based cross sectional study was conducted using data on 1,328 cancer patients collected from the Health Information National Trends Survey. Multivariable logistic regression analyses were used to analyze the relationship between race and financial toxicity, adjusting for known confounders. Results: Blacks, Hispanics and other races were shown to have a lower rate of insurance compared to Whites. Whites were also more likely to receive cancer treatment than other races (6.1% received no treatment vs 15.0% of Blacks, 17.8% of Hispanics, and 9.7% of other races, p<0.001). Considerably more Whites underwent surgical treatment of their cancer (77%) vs. 60% of Blacks, 55% of Hispanics and 74.2% of other races, p<0.001. Blacks were found to be over 5 times more likely to be denied insurance (OR 5.003, 95% CI 2.451-10.213, p<0.001) and more than twice as likely to be hurt financially than Whites (OR 2.448, 95% CI 1.520-3.941, p<0.001). Other racial minorities were also more than twice as likely to be hurt financially than Whites (OR 2.421, 95% CI 1.248-4.698, p=0.009) (Table). Conclusions: These data suggest that race is significantly associated with increased rates of being hurt financially and being denied insurance due to cancer. Awareness of race inequality should be raised so that equal cancer treatment can be provided, irrespective of race, gender or socioeconomic status.[Table: see text]


BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018986 ◽  
Author(s):  
Albert Roso-Llorach ◽  
Concepción Violán ◽  
Quintí Foguet-Boreu ◽  
Teresa Rodriguez-Blanco ◽  
Mariona Pons-Vigués ◽  
...  

ObjectiveThe aim was to compare multimorbidity patterns identified with the two most commonly used methods: hierarchical cluster analysis (HCA) and exploratory factor analysis (EFA) in a large primary care database. Specific objectives were: (1) to determine whether choice of method affects the composition of these patterns and (2) to consider the potential application of each method in the clinical setting.DesignCross-sectional study. Diagnoses were based on the 263 corresponding blocks of the International Classification of Diseases version 10. Multimorbidity patterns were identified using HCA and EFA. Analysis was stratified by sex, and results compared for each method.Setting and participantsElectronic health records for 408 994 patients with multimorbidity aged 45–64 years in 274 primary health care teams from 2010 in Catalonia, Spain.ResultsHCA identified 53 clusters for women, with just 12 clusters including at least 2 diagnoses, and 15 clusters for men, all of them including at least two diagnoses. EFA showed 9 factors for women and 10 factors for men. We observed differences by sex and method of analysis, although some patterns were consistent. Three combinations of diseases were observed consistently across sex groups and across both methods: hypertension and obesity, spondylopathies and deforming dorsopathies, and dermatitis eczema and mycosis.ConclusionsThis study showed that multimorbidity patterns vary depending on the method of analysis used (HCA vs EFA) and provided new evidence about the known limitations of attempts to compare multimorbidity patterns in real-world data studies. We found that EFA was useful in describing comorbidity relationships and HCA could be useful for in-depth study of multimorbidity. Our results suggest possible applications for each of these methods in clinical and research settings, and add information about some aspects that must be considered in standardisation of future studies: spectrum of diseases, data usage and methods of analysis.


2012 ◽  
Vol 39 (7) ◽  
pp. 1458-1464 ◽  
Author(s):  
DARIA B. CRITTENDEN ◽  
R. AARON LEHMANN ◽  
LAURA SCHNECK ◽  
ROBERT T. KEENAN ◽  
BINITA SHAH ◽  
...  

Objective.The ability of antiinflammatory strategies to alter cardiovascular risk has not been rigorously examined. Colchicine is an antiinflammatory agent that affects macrophages, neutrophils, and endothelial cells, all of which are implicated in the pathogenesis of cardiovascular disease. We examined whether colchicine use was associated with a reduced risk of myocardial infarction (MI) in patients with gout.Methods.We conducted a retrospective, cross-sectional study of all patients with an International Classification of Diseases, 9th ed, code for gout in the electronic medical record (EMR) of the New York Harbor Healthcare System Veterans Affairs network and ≥ 1 hospital visit between August 2007 and August 2008. Hospital pharmacy data were used to identify patients who had filled at least 1 colchicine prescription versus those who had not. Demographics and CV comorbidities were collected by EMR review. The primary outcome was diagnosis of MI. Secondary outcomes included all-cause mortality and C-reactive protein (CRP) level.Results.In total, 1288 gout patients were identified. Colchicine (n = 576) and no colchicine (n = 712) groups had similar baseline demographics and serum urate levels. Prevalence of MI was 1.2% in the colchicine versus 2.6% in the no-colchicine group (p = 0.03). Colchicine users also had fewer deaths and lower CRP levels, although these did not achieve statistical significance. Colchicine effects persisted when allopurinol users were excluded from the analysis.Conclusion.In this hypothesis-generating study, gout patients who took colchicine had a significantly lower prevalence of MI and exhibited trends toward reduced all-cause mortality and lower CRP level versus those who did not take colchicine.


2021 ◽  
Vol 71 (3) ◽  
pp. 734-38
Author(s):  
Ghazanfar Ali ◽  
Sikander Ali Khan ◽  
Muzzafar Ahmed ◽  
Muhammad Sheraz Afzal Malik ◽  
Danish Almas ◽  
...  

Objective: To evaluate the severity of depression and anxiety among patients of burns and correlate depression and anxiety with areas of body involved in burns. Study Design: A cross-sectional study. Place and Duration of Study: The departments of Psychiatry and department of Plastic Surgery, Combined Military Hospital Multan, from Oct 2019 to Mar 2020. Methodology: Through consecutive sampling, 56 patients of burns reporting to burns unit were assessed for anxiety and/ or depression based on the diagnostic criteria of International Classification of Diseases version 10. Symptom severity was assessed using Beck Depressive Inventory for depression and Beck Anxiety Inventory for anxiety. Descriptive statistics like mean with standard deviation was calculated for age. Frequency along with percentages was calculated for sociodemographic variables, Anxiety and depression. Results: Depression was present among 30 (53%) of participants out of which 16 (53.5%) had mild, 11 (37.9%) had moderate while only 3 (12.5%) had severe depression. Anxiety was seen among 50 (89%) of participants out of which sixteen (32.1%) had mild, 26 (51.7%) had moderate while 8 (16%) had severe anxiety. Significant correlation existed among the major area involved in burn with both anxiety and depression (p<0.01). Conclusion: There is a very high prevalence of anxiety and depression among patients of burn. Significant positive correlation existed between the level of anxiety and the areas involved in burns.


Author(s):  
Francisco José Sánchez-Torralvo ◽  
Victoria Contreras-Bolívar ◽  
María Ruiz-Vico ◽  
José Abuín-Fernández ◽  
Inmaculada González-Almendros ◽  
...  

Abstract Background Anxiety and depression are a common issue in patients with cancer, yet understudied among hospitalized patients. The aim of this study was to estimate the prevalence of anxiety and depression symptomatology in cancer inpatients and its relationship with malnutrition. Methods Cross-sectional study in hospitalized cancer patients. A nutritional assessment was done using the Global Leadership Initiative on Malnutrition (GLIM) criteria to diagnose malnutrition. Data regarding anxiety and depression symptomatology was obtained with the Hospital Anxiety and Depression Scale (HADS). Results A total of 282 inpatients were assessed. GLIM criteria found 20% (66) of well-nourished and 80% (216) with malnutrition. HADS presented an average score of 8.3 ± 4.4 with respect to anxiety and an average score of 7.7 ± 4.6 with respect to depression. Up to 54% of the patients showed a possible presence of anxiety, and 45.3% of them showed a possible presence of depression. In malnourished patients, HADS score was non-significantly higher with respect to anxiety (8.5 ± 4.3 in malnourished vs 7.1 ± 4.6 in well-nourished; p = 0.06) and was significantly higher with respect to depression (8.2 ± 4.6 in malnourished vs 5.3 ± 4.0 in well-nourished; p < 0.001). After controlling for potential confounders, malnourished patients were 1.98 times more likely to present anxious symptomatology (95% CI 1.01–3.98; p = 0.049) and 6.29 times more likely to present depressive symptomatology (95% CI 1.73–20.47; p = 0.005). Conclusions The presence of anxiety and depression symptomatology in oncological inpatients is high. There is an association between malnutrition and presenting anxious and depressive symptomatology in hospitalized cancer patients.


2021 ◽  
Vol 14 (11) ◽  
pp. 1765-1770
Author(s):  
Carlos Cifuentes-González ◽  
◽  
Juliana Reyes-Guanes ◽  
Pilar Uribe-Reina ◽  
Alejandra de-la-Torre ◽  
...  

AIM: To provide an epidemiological characterization of ocular cicatricial pemphigoid (OCP) in Colombia. METHODS: We conducted a cross-sectional study using SISPRO. We applied the specific code of the International Classification of Diseases for Ocular Pemphigoid, from 2009-2019 to estimate prevalence, incidence, and the demographic status of the disease in Colombia. RESULTS: The estimated average prevalence was 0.22 per 1 000 000 inhabitants, and the estimated average incidence was 0.24 per 1 000 000 inhabitants. With a female predominance of 62.5%, and a male/female ratio of 1:1.6. The group of patients diagnosed with the disease after the age of 80 presented the highest prevalence. The departments with the highest prevalence were Antioquia, Bogotá, and Santander. CONCLUSION: There are important differences between worldwide and Colombian prevalence and incidence data, which may be related to genetic and epigenetic factors, and the possible underdiagnosis of the disease. According to the results, OCP is an extremely rare disease in Colombia. Nevertheless, it is important to encourage awareness of the disease due to its devastating consequences.


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