Chronic opioid use in women following hysterectomy: Patterns and predictors

Background Most women are prescribed an opioid after hysterectomy. The goal of this study was to determine the association between initial opioid prescribing characteristics and chronic opioid use after hysterectomy. Methods This study included women enrolled in a commercial health plan who had a hy...

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Bibliographic Details
Published in:Pharmacoepidemiology and drug safety 2020-04, Vol.29 (4), p.493-503
Main Authors: Wen, Xuerong, Kogut, Stephen, Aroke, Hilary, Taylor, Lynn, Matteson, Kristen A.
Format: Article
Language:English
Subjects:
Adult
Aged
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - adverse effects
chronic opioid use
Cohort Studies
Drug Administration Schedule
Drug Prescriptions
Female
Headache
Humans
Hysterectomy
Hysterectomy - adverse effects
Hysterectomy - trends
Laparoscopy
Middle Aged
Narcotics
Opioid-Related Disorders - epidemiology
Opioid-Related Disorders - prevention & control
Opioids
Pain, Postoperative - epidemiology
Pain, Postoperative - prevention & control
Predictive Value of Tests
predictors
Robotic surgery
Surgery
Tobacco
Young Adult
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Summary:Background Most women are prescribed an opioid after hysterectomy. The goal of this study was to determine the association between initial opioid prescribing characteristics and chronic opioid use after hysterectomy. Methods This study included women enrolled in a commercial health plan who had a hysterectomy between 1 July 2010 and 31 March 2015. We used trajectory models to define chronic opioid use as patients with the highest probability of having an opioid prescription filled during the 6 months post‐surgery. A multivariable logistic regression was applied to examine the association between initial opioid dispensing (amount prescribed and duration of treatment) and chronic opioid use after adjusting for potential confounders. Results A total of 693 of 50 127 (1.38%) opioid‐naïve women met the criteria for chronic opioid use following hysterectomy. The baseline variables and initial opioid prescription characteristics predicted the pattern of long‐term opioid use with moderate discrimination (c statistic = 0.70). Significant predictors of chronic opioid use included initial opioid daily dose (≥60 MME vs
ISSN:1053-8569
1099-1557
DOI:10.1002/pds.4972