The prevalence and economic impact of prescription opioid-related side effects among patients with chronic noncancer pain

2013 ◽  
Vol 9 (4) ◽  
pp. 239-254 ◽  
Author(s):  
Jasmina I. Ivanova, MA ◽  
Howard G. Birnbaum, PhD ◽  
Yana Yushkina, BA ◽  
Rachael A. Sorg, MPH ◽  
John Reed, MD ◽  
...  
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Healthcare Costs ◽  
Claims Data ◽  
Patient Survey ◽  
Prescription Opioid ◽  
Chronic Noncancer Pain ◽  
Medical Group Practice ◽  
Outcomes Measures ◽  
Noncancer Pain

Objectives: To estimate the prevalence of opioid-related side effects among patients with chronic noncancer pain (CNCP) who initiated opioids and compare healthcare costs of patients with and without side effects using patient survey, medical charts, and claims data.Patients, participants: Patients initiating opioids, who were aged ≥18 years, had ≥1 pain diagnosis, and did not have cancer, were identified through claims data and medical records from a Central Massachusetts medical group practice and mailed surveys between October 2010 and July 2012.Main outcomes measures: Prevalence of opioid-related side effects was estimated from patient surveys, charts, and claims data within 90 days after opioid initiation (study period). Study period healthcare costs were compared between patients with and without side effects (self-reported problematic side effects or side effects recorded in medical charts or claims).Results: Among patients with CNCP who initiated opioids and completed the survey (N = 167), the average age was 53 years, and 62.9 percent were women. Based on the survey, charts, and claims, 91.6 percent, 15.0 percent, and 19.2 percent of patients, respectively, had ≥1 opioid-related side effect. Overall, 59.3 percent of patients reported having ≥1 problematic side effect or side effect recorded in charts or claims. In the analysis that controlled for baseline characteristics and resource use, patients with versus without side effects had higher mean study period healthcare costs ($3,347 vs $2,521, p = 0.049).Conclusions: Prevalence of opioid-related side effects among patients with CNCP who initiated opioids was substantially higher based on patient survey than from charts or claims. Opioid-related side effects were associated with significantly higher healthcare costs.

scholarly journals Abuse-deterrent formulations of prescription opioid analgesics in the management of chronic noncancer pain

2016 ◽  
Vol 6 (5) ◽  
pp. 497-508 ◽  
Author(s):  
Martin E Hale ◽  
Derek Moe ◽  
Mary Bond ◽  
Maciej Gasior ◽  
Richard Malamut
Keyword(s):  
Opioid Analgesics ◽  
Prescription Opioid ◽  
Chronic Noncancer Pain ◽  
Prescription Opioid Analgesics ◽  
Noncancer Pain

Management of opioid side effects in cancer-related and chronic noncancer pain: a systematic review

2003 ◽  
Vol 4 (5) ◽  
pp. 231-256 ◽  
Author(s):  
Ewan McNicol ◽  
Nathalie Horowicz-Mehler ◽  
Ruth A Fisk ◽  
Kyle Bennett ◽  
Maria Gialeli-Goudas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain

scholarly journals Exploring the Lived Experience of Adults using Prescription Opioids to Manage Chronic Noncancer Pain

2015 ◽  
Vol 20 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Erica A Brooks ◽  
Anita Unruh ◽  
Mary E Lynch
Keyword(s):  
Lived Experience ◽  
Quantitative Research ◽  
Qualitative Interviews ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Opioid Use ◽  
Chronic Noncancer Pain ◽  
Positive Effects ◽  
Noncancer Pain ◽  
Dimensions Of Pain

BACKGROUND: Chronic noncancer pain (CNCP) and prescription opioid use is a highly complex and growing health care issue in Canada. Many quantitative research studies have investigated the effectiveness of opioids for chronic pain; however, gaps remain in the literature regarding the personal experience of using opioids and their impact on those experiencing CNCP.OBJECTIVE: To explore the lived experience of adults using prescription opioids to manage CNCP, focusing on how opioid medication affected their daily lives.METHODS: In-depth qualitative interviews were conducted with nine adults between 40 and 68 years of age who were using prescription opioids daily for CNCP. Interviews were audiorecorded and transcribed, and subsequently analyzed using interpretive phenomenological analysis.RESULTS: Six major themes identified positive and negative aspects of opioid use associated with social, physical, emotional and psychological dimensions of pain management. These themes included the process of decision making, and physical and psychosocial consequences of using opioids including pharmacological side effects, feeling stigmatized, guilt, fears, ambivalence, self-protection and acceptance.CONCLUSION: Although there were many negative aspects to using opioids daily, the positive effects outweighed the negative for most participants and most of the negative aspects were socioculturally induced rather than caused by the drug itself. The present study highlighted the complexities involved in using prescription opioids daily for management of CNCP for individuals living with pain.

The need for improvement in the management of fatigue, depression and pain in pancreatic cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 429-429
Author(s):  
Amy Westermann ◽  
Lynn McCormick Matrisian ◽  
Lola Rahib
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Side Effects ◽  
Side Effect ◽  
Healthcare Costs ◽  
Pain Medication ◽  
Patient Registry ◽  
Patient Reported

429 Background: Pancreatic cancer (PC) and its treatment(s) results in symptom and side effect burden and can impact patient’s overall quality of life (QOL). Methods: Patient reported information on management of side effects and symptoms were collected using PanCAN’s Patient Registry (01/2016 – 07/2018). Results: Patient reported information on side effects, pain and depression is detailed in the table. Side effects: 94% reported fatigue and 8% reported taking anti-fatigue medication. 72% reported nausea or vomiting during treatment and 83% reported taking anti-nausea medication. Pain: Of the 90% of patients who reported pain related to PC, 27% did not take pain medication, 47% visited the ER and 32% were hospitalized due to pain. Depression: Of the 83% of users reported feeling depressed during PC, 46% were diagnosed with depression, 37% prescribed anti-depressant, and 48% did not see a therapist. Conclusions: Nausea was reported as most managed. Fatigue, pain and depression were generally unmanaged. ER visits and hospitalizations due to pain were frequently reported. An improvement in the management of these side effects and symptoms is needed as it can affect patient’s ability to tolerate treatment, improve overall QOL, and may lower overall healthcare costs. [Table: see text]

Opioid Misuse and Addiction Among Patients With Chronic Pain

2019 ◽  
pp. 339-354
Author(s):  
Marc O. Martel ◽  
Robert N. Jamison
Keyword(s):  
Chronic Pain ◽  
Opioid Therapy ◽  
Screening Tools ◽  
Prescription Opioid ◽  
Opioid Misuse ◽  
Chronic Noncancer Pain ◽  
Medication Misuse ◽  
Opioid Medications ◽  
Noncancer Pain

Chapter 20 provides an introduction to understanding the prevalence and risk factors as well as screening tools for assessing opioid misuse and addiction in patients with chronic pain. In the era of the opioid epidemic in North America and beyond, the use of prescription opioid medications to help improve function in chronic noncancer pain is frequently debated. Out of fear of iatrogenic addiction, litigation, and/or potential medication misuse, some clinicians are refusing to prescribe opioids for chronic pain. Evidence indicates that rates of opioid misuse and addiction are fairly high among chronic pain patients prescribed long-term opioid therapy, but there is consensus that opioids can be safe and effective for carefully selected and monitored patients.

A Novel Treatment for Opioid-Induced Constipation After Abdominoplasty

2017 ◽  
Vol 34 (4) ◽  
pp. 200-203
Author(s):  
R. Chad Deal ◽  
Talon Maningas ◽  
Ricardo Bonnor ◽  
Trent Fogleman
Keyword(s):  
Drug Administration ◽  
Side Effect ◽  
Food And Drug Administration ◽  
Pain Medication ◽  
Current Treatment ◽  
Chronic Noncancer Pain ◽  
Novel Treatment ◽  
Novel Approach ◽  
Bowel Movements ◽  
Noncancer Pain

Opioid-induced constipation (OIC) is a commonly experienced side effect of those utilizing narcotic pain medication. The current treatment for OIC commonly consists of stool softeners and bowel stimulants which often leads to abdominal bloating and discomfort ultimately resulting in uncomfortable bowel movements and loose stools. We present a novel approach to the treatment of acute OIC after abdominoplasty in patients taking narcotic pain medication utilizing a well-known medication currently approved by the Food and Drug Administration for the treatment of OIC in adult patients with chronic noncancer pain.

scholarly journals Patterns and Correlates of Prescription Opioid Use in OEF/OIF Veterans with Chronic Noncancer Pain

Pain Medicine ◽  
2011 ◽  
Vol 12 (10) ◽  
pp. 1502-1509 ◽  
Author(s):  
Tara A. Macey ◽  
Benjamin J. Morasco ◽  
Jonathan P. Duckart ◽  
Steven K. Dobscha
Keyword(s):  
Prescription Opioid ◽  
Opioid Use ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain ◽  
Prescription Opioid Use

scholarly journals Prescription Opioid Abuse in Chronic Pain: A Review of Opioid Abuse Predictors and Strategies to Curb Opioid Abuse

2012 ◽  
Vol 3S;15 (3S;7) ◽  
pp. S67-ES92 ◽  
Author(s):  
Nalini Sehgal
Keyword(s):  
Chronic Pain ◽  
Opioid Therapy ◽  
Opioid Abuse ◽  
Screening Tools ◽  
Prescription Opioid ◽  
Prescribing Practices ◽  
Chronic Noncancer Pain ◽  
The Past ◽  
Noncancer Pain ◽  
Prescription Opioid Abuse

Both chronic pain and prescription opioid abuse are prevalent and continue to exact a heavy toll on patients, physicians, and society. Individuals with chronic pain and co-occurring substance use disorders and/or mental health disorders, are at a higher risk for misuse of prescribed opioids. Opioid abuse and misuse occurs for a variety of reasons, including self medication, use for reward, compulsive use because of addiction, and diversion for profit. Treatment approaches that balance treating chronic pain while minimizing risks for opioid abuse, misuse, and diversion are much needed. The use of chronic opioid therapy for chronic noncancer pain has increased dramatically in the past 2 decades in conjunction with a marked increase in the abuse of prescribed opioids and accidental opioid overdoses. Consequently, a validated screening instrument that provides an effective and rational method of selecting patients for opioid therapy, predicting risk, and identifying problems once they arise could be of enormous benefit. Such an instrument could potentially curb the risk of iatrogenic addiction. Although several screening instruments and strategies have been introduced in the past decade, there is no single test or instrument that can reliably and accurately predict patients who are not suitable for opioid therapy or identify those who need increased vigilance or monitoring during therapy. At present, screening for opioid abuse includes assessment of premorbid and comorbid substance abuse; assessment of aberrant drug-related behaviors; risk factor stratification; and utilization of opioid assessment screening tools. Multiple opioid assessment screening tools and instruments have been developed by various authors. In addition, urine drug testing, monitoring of prescribing practices, prescription monitoring programs, opioid treatment agreements, and utilization of universal precautions are essential. Presently, a combination of strategies is recommended to stratify risk, identify and understand aberrant drug related behaviors, and tailor treatments accordingly. This manuscript will review the current state of knowledge regarding the growing problem of opioid abuse and misuse; known risk factors; and methods of predicting, assessing, monitoring, and addressing opioid abuse and misuse in patients with chronic noncancer pain. Key words: Opioids, misuse, abuse, chronic pain, prevalence, risk assessment, risk management, drug monitoring, aberrant drug-related behavior

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