Prescription Opioids Dispensed to Patients with Cancer with Bone Metastasis: 2011-2017.
Hao ZhangJudith PaiceRussell PortenoyEduardo BrueraM Carrington ReidYuhua BaoPublished in: The oncologist (2021)
Opioid therapy is a first-line approach for moderate-to-severe pain associated with cancer with bone metastasis (CBM). The decade-long decline in opioid prescribing in the U.S. would not be expected to affect patients with CBM. We investigated trends in opioids dispensed to patients with CBM using data from a large commercial claims database. From 2011 quarter 2 to 2017 quarter 4, the percentage of patients with CBM prescribed at least 1 day of opioids in a quarter declined from 28.1% to 24.5% (p < .001) for privately insured patients aged 18-64 years and from 39.1% to 30.5% (p < .001) for Medicare Advantage (MA) patients aged 65 years or older. Among patients with at least 1 day of opioids in a quarter, the average morphine milligram equivalents dispensed declined by 37% and 11% (p < .001 for both) for privately insured and MA patients, respectively. Our findings raise concerns about potential unintended consequences related to population-level reduction in opioid prescribing.
Keyphrases
- chronic pain
- pain management
- ejection fraction
- newly diagnosed
- primary care
- prognostic factors
- stem cells
- machine learning
- emergency department
- chronic kidney disease
- patient reported outcomes
- early onset
- mesenchymal stem cells
- electronic health record
- spinal cord
- bone mineral density
- health insurance
- single molecule
- neuropathic pain
- lymph node metastasis
- data analysis
- community dwelling