Utility of accumulated opioid supply days and individual patient factors in predicting probability of transitioning to long‐term opioid use: An observational study in the Veterans Health Administration

Initial supply days dispensed to new users is strongly predictive of future long‐term opioid use (LTO). The objective was to examine whether a model integrating additional clinical variables conferred meaningful improvement in predicting LTO, beyond a simple approach using only accumulated supply. T...

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Published in:Pharmacology research & perspectives 2020-04, Vol.8 (2), p.e00571-n/a
Main Authors: Hadlandsmyth, Katherine, Mosher, Hilary J., Vander Weg, Mark W., O’Shea, Amy M., McCoy, Kimberly D., Lund, Brian C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - supply & distribution
Drug Prescriptions - statistics & numerical data
Drug Utilization
Female
Humans
Intervention
long‐term
Male
medical record data
Middle Aged
Narcotics
Observational studies
opioid
Opioid-Related Disorders
Original
Patients
Pharmacology
Prescriptions
Risk
Time Factors
United States
United States Department of Veterans Affairs - statistics & numerical data
Variables
Veteran
Veterans Health
Young Adult
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description Initial supply days dispensed to new users is strongly predictive of future long‐term opioid use (LTO). The objective was to examine whether a model integrating additional clinical variables conferred meaningful improvement in predicting LTO, beyond a simple approach using only accumulated supply. Three cohorts were created using Veteran's Health Administration data based on accumulated supply days during the 90 days following opioid initiation: (a)
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The objective was to examine whether a model integrating additional clinical variables conferred meaningful improvement in predicting LTO, beyond a simple approach using only accumulated supply. Three cohorts were created using Veteran's Health Administration data based on accumulated supply days during the 90 days following opioid initiation: (a) &lt;30 days, (b) ≥30 days, (c) ≥60 days. A base, unadjusted probability of subsequent LTO (days 91‐365) was calculated for each cohort, along with an associated risk range based on midpoint values between cohorts. Within each cohort, log‐binomial regression modeled the probability of subsequent LTO, using demographic, diagnostic, and medication characteristics. Each patient's LTO probability was determined using their individual characteristic values and model parameter estimates, where values falling outside the cohort's risk range were considered a clinically meaningful change in predictive value. 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source Open Access: PubMed Central; Wiley Online Library Open Access; Publicly Available Content Database
subjects Adolescent
Adult
Aged
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - supply & distribution
Drug Prescriptions - statistics & numerical data
Drug Utilization
Female
Humans
Intervention
long‐term
Male
medical record data
Middle Aged
Narcotics
Observational studies
opioid
Opioid-Related Disorders
Original
Patients
Pharmacology
Prescriptions
Risk
Time Factors
United States
United States Department of Veterans Affairs - statistics & numerical data
Variables
Veteran
Veterans Health
Young Adult
title Utility of accumulated opioid supply days and individual patient factors in predicting probability of transitioning to long‐term opioid use: An observational study in the Veterans Health Administration
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