Associations of Early Opioid Use with Patient-reported Outcomes and Health Care Utilization among Older Adults with Low Back Pain

Laura S. Gold, Ryan N. Hansen, Andrew L. Avins, Zoya Bauer, Bryan A. Comstock, Richard (Rick) Deyo, Patrick J. Heagerty, Sean D. Rundell, Pradeep Suri, Judith A. Turner, Jeffrey G. Jarvik

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: The objective of this study was to compare outcomes and health care utilization of older patients who did versus did not fill opioid prescriptions within 90 days of initiating care for low back pain. Materials and Methods: For patients ≥65 years with new back pain visits, we used propensity scores to match those who filled no opioid prescriptions to those who filled ≥2 opioid prescriptions within 90 days (and the first opioid prescription within 30 d) of the index visit. Over 24 months, we examined patient-reported outcomes, health care utilization, and subsequent opioid prescription fills. Results: Among 1954 patients eligible for matching, 238 (12%) filled ≥2 opioid prescriptions within 90 days; 200 of these were matched to controls. Patients with versus without early opioid prescriptions had similar patient-reported outcomes but were more likely to have filled ≥1 opioid prescription 18 to 24 months after the index visit (odds ratio [95% confidence interval]=2.4 [1.5-3.9]) and to have had ≥1 visit to the emergency department in the subsequent 24 months (OR, 1.6; 95% confidence interval, 1.0-2.5). Discussion: Among older patients with new back pain visits, filling ≥2 opioid prescriptions within 90 days of the visit was associated with similar back pain-related outcomes but increased likelihood of filling opioid prescriptions 18 to 24 months later compared with matched patients who did not fill early opioid prescriptions.

Original languageEnglish (US)
Article number0557
Pages (from-to)297-305
Number of pages9
JournalClinical Journal of Pain
Volume34
Issue number4
DOIs
StatePublished - Jan 1 2018

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Patient Acceptance of Health Care
Low Back Pain
Opioid Analgesics
Prescriptions
Back Pain
Patient Reported Outcome Measures
Confidence Intervals
Propensity Score
Hospital Emergency Service

Keywords

  • low back pain
  • opioids
  • patient-reported outcomes
  • Roland-Morris Disability Questionnaire (RMDQ)

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Associations of Early Opioid Use with Patient-reported Outcomes and Health Care Utilization among Older Adults with Low Back Pain. / Gold, Laura S.; Hansen, Ryan N.; Avins, Andrew L.; Bauer, Zoya; Comstock, Bryan A.; Deyo, Richard (Rick); Heagerty, Patrick J.; Rundell, Sean D.; Suri, Pradeep; Turner, Judith A.; Jarvik, Jeffrey G.

In: Clinical Journal of Pain, Vol. 34, No. 4, 0557, 01.01.2018, p. 297-305.

Research output: Contribution to journalArticle

Gold, LS, Hansen, RN, Avins, AL, Bauer, Z, Comstock, BA, Deyo, RR, Heagerty, PJ, Rundell, SD, Suri, P, Turner, JA & Jarvik, JG 2018, 'Associations of Early Opioid Use with Patient-reported Outcomes and Health Care Utilization among Older Adults with Low Back Pain', Clinical Journal of Pain, vol. 34, no. 4, 0557, pp. 297-305. https://doi.org/10.1097/AJP.0000000000000557
Gold, Laura S. ; Hansen, Ryan N. ; Avins, Andrew L. ; Bauer, Zoya ; Comstock, Bryan A. ; Deyo, Richard (Rick) ; Heagerty, Patrick J. ; Rundell, Sean D. ; Suri, Pradeep ; Turner, Judith A. ; Jarvik, Jeffrey G. / Associations of Early Opioid Use with Patient-reported Outcomes and Health Care Utilization among Older Adults with Low Back Pain. In: Clinical Journal of Pain. 2018 ; Vol. 34, No. 4. pp. 297-305.
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