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Associations of Early Opioid Use with Patient-Reported Outcomes and Healthcare Utilization Among Older Adults with Low Back Pain.

Gold, Laura S. PhD; Hansen, Ryan N. PharmD, PhD; Avins, Andrew L. MD; Bauer, Zoya MD, PhD; Comstock, Bryan A. MS; Deyo, Richard A. MD, MPH; Heagerty, Patrick J. PhD; Rundell, Sean D. DPT, PhD; Suri, Pradeep MD, MS; Turner, Judith A. PhD; Jarvik, Jeffrey G. MD, MPH
Clinical Journal of Pain: Post Acceptance: September 14, 2017
doi: 10.1097/AJP.0000000000000557
Original Article: PDF Only

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.

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