Objectives: To compare outcomes and healthcare 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, healthcare 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 18-24 months after the index visit (odds ratio (95% CI)=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% CI 1.0-2.5).
Discussion: Among older patients with new back pain visits, filling >=2 opioid prescriptions within 90 days of a the visit was associated with similar back pain-related outcomes but increased likelihood of filling opioid prescriptions 18-24 months later compared to matched patients who did not fill early opioid prescriptions.
Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.