scholarly journals Sick Leave and Costs in Active Workers With Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study

2020 ◽  
Author(s):  
Antoni Sicras-Mainar ◽  
Juan Carlos Tornero ◽  
F Vargas ◽  
I Lizarraga ◽  
A Sicras ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Sick Leave ◽  
Pain Reduction ◽  
Opioid Use ◽  
Opioid Treatment ◽  
Female Sex ◽  
Strong Opioid ◽  
Osteoarthritis Pain ◽  
Strong Opioids ◽  
The Cost

Abstract ObjectiveTo evaluate sick leave and its costs in active workers who initiate opioid treatment for moderate/severe chronic osteoarthritis (OA) pain.MethodsSecondary analysis of the longitudinal, retrospective OPIOIDS study using electronic medical records (EMR) of patients aged ≥ 18 years who started opioid treatment for chronic OA pain between 2010 and 2015 after treatment failure with usual analgesics. The follow-up period was 36 months from the index date, and the days of sick leave and their cost were analyzed.ResultsA total of 5,089 EMRs of OA chronic pain patients aged 56.8 years (SD: 4.6), 56.6% male, were analyzed: 73.3% of patients started treatment with a weak opioid and 26.7% a strong opioid. At 36 months, adherence was 21% (strong opioids 15.4%, weak opioids: 23%; p<0.001), and 77% of patients had at least one sick leave related with OA chronic pain, with a mean total days off work of 93 days in all actively working patients (120.5 days in patients with sick leaves). In 16.9% it lasted ≥ 6 months. Pain reduction was modest (-1.2 points; -4.0%, p<0.001). The cost of sick leave was € 2,594 patient/year and was associated (p<0.05) with age (β-0.043), female sex (β-0.035), comorbidity (β-0.034) and strong opioid use (β-0.037).ConclusionsActive workers who started opioid treatment for chronic osteoarthritis pain showed an increased frequency of sick leave and cost to society, with modest pain reduction. Age, female sex, comorbidity, and strong opioids were factors associated with the cost of sick leave.

Pharmaceutical treatment patterns for patients with a diagnosis related to chronic pain initiating a slow-release strong opioid treatment in Sweden

Pain ◽  
2012 ◽  
Vol 153 (12) ◽  
pp. 2325-2331 ◽  
Author(s):  
A. Gustavsson ◽  
J. Bjorkman ◽  
C. Ljungcrantz ◽  
A. Rhodin ◽  
M. Rivano-Fischer ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Slow Release ◽  
Treatment Patterns ◽  
Pharmaceutical Treatment ◽  
Opioid Treatment ◽  
Strong Opioid

scholarly journals Prevalence and duration of prescribed opioid use during pregnancy: a cohort study from the Quebec Pregnancy Cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jin-Ping Zhao ◽  
Christelle Berthod ◽  
Odile Sheehy ◽  
Behrouz Kassaï ◽  
Jessica Gorgui ◽  
...  
Keyword(s):  
Opioid Use ◽  
Duration Of Treatment ◽  
Duration Of Action ◽  
Strong Opioid ◽  
Pregnancy Cohort ◽  
Cumulative Duration ◽  
Long Acting ◽  
Strong Opioids ◽  
Opioid Users ◽  
Weak Opioid

Abstract Background Recent studies show a rapid growth among pregnant women using high potency opioids for common pain management during their pregnancy. No study has examined the duration of treatment among strong opioid users and weak opioid users during pregnancy. We aimed to investigate the prevalence of prescribed opioid use during pregnancy, in Quebec; and to compare the duration of opioid treatment between strong opioid users and weak opioid users. Methods Using the Quebec Pregnancy Cohort (1998–2015), we included all pregnancies covered by the Quebec Public Prescription Drug Insurance Program. Opioid exposure was defined as filled at least one prescription for any opioid during pregnancy or before pregnancy but with a duration that overlapped the beginning of pregnancy. Prevalence of opioids use was calculated for all pregnancies, according to pregnancy outcome, trimester of exposure, and individual opioids. The duration of opioid use during pregnancy was analyzed according to 8 categories based on cumulative duration (< 90 days vs. ≥90 days), duration of action (short-acting vs. long-acting) and strength of the opioid (weak vs. strong). Results Of 442,079 eligible pregnancies, 20,921 (4.7%) were exposed to opioids. Among pregnancies ending with deliveries (n = 249,234), 5.4% were exposed to opioids; the prevalence increased by 40.3% from 3.9% in 1998 to 5.5% in 2015, more specifically a significant increase in the second and third trimesters of pregnancy. Weak opioid, codeine was the most commonly dispensed opioid (70% of all dispensed opioids), followed by strong opioid, hydromorphone (11%), morphine (10%), and oxycodone (5%). The prevalence of codeine use decreased by 47% from 4.3% in 2005 to 2.3% in 2015, accompanied by an increased use of strong opioid, morphine (0.029 to 1.41%), hydromorphone (0.115 to 1.08%) and oxycodone (0.022 to 0.44%), from 1998 to 2015. The average durations of opioid exposure were significantly longer among pregnancies exposed to strong opioid as compared to weak opioid regardless of the cumulative duration or duration of action (P < 0.05). Conclusions Given the differences in the safety profile between strong opioids and the major weak opioid codeine, the increased use of strong opioids during pregnancy with longer treatment duration raises public health concerns.

scholarly journals Health outcomes and costs in patients with osteoarthritis and chronic pain treated with opioids in Spain: the OPIOIDS real-world study

2020 ◽  
Vol 12 ◽  
pp. 1759720X2094200
Author(s):  
Antoni Sicras-Mainar ◽  
Carlos Tornero-Tornero ◽  
Francisco Vargas-Negrín ◽  
Isabel Lizarraga ◽  
Javier Rejas-Gutierrez
Keyword(s):  
Chronic Pain ◽  
Health Outcomes ◽  
Resource Utilization ◽  
Real World ◽  
Hospital Admissions ◽  
National Health System ◽  
Pain Reduction ◽  
Opioid Use ◽  
Usual Practice ◽  
Surgical Interventions

Objective: The objective of this study was to analyze health outcomes, resource utilization, and costs in osteoarthritis patients with chronic nociceptive pain who began treatment with an opioid in real-world practice in Spain. Methods: We designed a non-interventional, retrospective, longitudinal study with 36 months of follow-up using electronic medical records (EMRs) from primary care centers, of patients aged 18+ years who began a new treatment with an opioid drug in usual practice for chronic pain due to osteoarthritis. Health/non-health resource utilization and costs, treatment adherence, pain change, cognitive functioning, and dependence for basic activities of daily living (BADL) were assessed. Results: A total of 38,539 EMRs [mean age (SD); 70.8 (14.3) years, 72.3% female; 53.3% hip/knee, 25.0% spine, and 21.7% other sites] were recruited. A total of 19.1% of patients remained on initial opioid at 36 months, without significant differences by osteoarthritis site ( p = 0.125). Mean total adjusted cost was €17,915, with 27.7% corresponding to healthcare resources and 72.3% to lost productivity. Hospital admissions for osteoarthritis-related surgical interventions accounted for 15.8% of total healthcare cost. A slight mean pain reduction was observed: –1.3 points, –16.9%, p < 0.001, with increases in cognitive deficit (+3.3%, p < 0.001) and moderate to total dependence for BADL (+15.6%, p < 0.001) in a median duration of opioid use of 203 days (IQR: 89–696). Conclusions: In real-world practice in Spain, opioid use in osteoarthritis was high, but with low adherence. There were meaningful increases in resource use and costs for the National Health System. Pain reduction was modest, whereas cognitive impairment and dependence for BADL increased significantly.

scholarly journals PCN58 The Cost of Strong Opioid Treatment of Oncological Pain in the Brazilian Private Health Care System

2011 ◽  
Vol 14 (7) ◽  
pp. A444
Author(s):  
E.D.M.P. Paloni ◽  
F. Bonachela Alves ◽  
A.D. Morais ◽  
M.L. Pereira ◽  
L. Bahmdouni
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Private Health Care ◽  
Opioid Treatment ◽  
Strong Opioid ◽  
The Cost ◽  
Care System

scholarly journals Opioids and Chronic Pain: An Analytic Review of the Clinical Evidence

2021 ◽  
Vol 2 ◽  
Author(s):  
Stephen E. Nadeau ◽  
Jeffrey K. Wu ◽  
Richard A. Lawhern
Keyword(s):  
Chronic Pain ◽  
Scientific Evidence ◽  
The United States ◽  
Opioid Therapy ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Opioid Treatment ◽  
Opioid Dose ◽  
Risk Of Death ◽  
Analytic Review

We conducted an analytic review of the clinical scientific literature bearing on the use of opioids for treatment of chronic non-cancer pain in the United States. There is substantial, albeit not definitive, scientific evidence of the effectiveness of opioids in treating pain and of high variability in opioid dose requirements and side effects. The estimated risk of death from opioid treatment involving doses above 100 MMED is ~0.25%/year. Multiple large studies refute the concept that short-term use of opioids to treat acute pain predisposes to development of opioid use disorder. The prevalence of opioid use disorder associated with prescription opioids is likely &lt;3%. Morbidity, mortality, and financial costs of inadequate treatment of the 18 million Americans with moderate to severe chronic pain are high. Because of the absence of comparative effectiveness studies, there are no scientific grounds for considering alternative non-pharmacologic treatments as an adequate substitute for opioid therapy but these treatments might serve to augment opioid therapy, thereby reducing dosage. There are reasons to question the ostensible risks of co-prescription of opioids and benzodiazepines. As the causes of the opioid crisis have come into focus, it has become clear that the crisis resides predominantly in the streets and that efforts to curtail it by constraining opioid treatment in the clinic are unlikely to succeed.

Retrospective analysis on the effect of spinal cord stimulation on opioid consumption

2020 ◽  
Author(s):  
Awinita Barpujari ◽  
Michael A Erdek
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Retrospective Analysis ◽  
Spinal Cord Stimulation ◽  
Alternative Therapy ◽  
Opioid Consumption ◽  
Opioid Use ◽  
Number Of Patients ◽  
Chronic Pain Conditions ◽  
Post Trial

Aim: Spinal cord stimulation (SCS) is used to clinically manage and/or treat several chronic pain etiologies. A limited amount is known about the influence on patients' use of opioid pain medication. This retrospective analysis evaluated SCS effect on opioid consumption in patients presenting with chronic pain conditions. Materials & methods: Sixty-seven patients underwent a temporary trial device, permanent implant or both. Patients were divided for assessment based on the nature of their procedure(s). Primary outcome was change in morphine equivalent dose (MED), ascertained from preoperative and postoperative medication reports. Results: Postoperative MED was significantly lower in patients who received some form of neuromodulation therapy. Pretrial patients reported an average MED of 41.01 ± 10.23 mg per day while post-trial patients reported an average of 13.30 ± 5.34 mg per day (p < 0.001). Pre-implant patients reported an average MED of 39.14 ± 13.52 mg per day while post-implant patients reported an average MED of 20.23 ± 9.01 mg per day (p < 0.001). There were no significant differences between pre-trial and pre-implant MED, nor between post-trial and post-implant MED. Of the 42 study subjects who reported some amount of pre-intervention opioid use, 78.57% indicated a lower MED (n = 33; p < 0.001), 16.67% indicated no change (n = 7) and 4.76% (n = 2) indicated a higher MED, following intervention. Moreover, SCS therapy resulted in a 26.83% reduction (p < 0.001) in the number of patients with MED >50 mg per day. Conclusion: Spinal cord stimulation may reduce opioid use when implemented appropriately. Neuromodulation may represent alternative therapy for alleviating chronic pain which may avoid a number of deleterious side effects commonly associated with opioid consumption.

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