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Opioid Pain Medication Use in New Urogynecology Patients

Dwarica, Denicia S., MD*; Rubenstein, Abby R., BS; Boccaccio, Robert B., DO; Motwani, Anita K., BS; Peck, Jennifer D., PhD§; LeClaire, Edgar L., MD*; Quiroz, Lieschen H., MD*

Female Pelvic Medicine & Reconstructive Surgery: September 20, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000627
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Objectives The aim of this study was to determine the prevalence of opioid pain medication use among patients presenting for a new visit to the urogynecology clinic compared with those presenting to general gynecology.

Methods We identified all patients who presented for new patient visits to the urogynecology and gynecology clinics between January 1, 2016, and December 31, 2016. Any previous or current opioid use was extracted from the electronic medical record medication list. Statistical analysis was performed using χ2 and Fisher exact tests for comparisons of categorical variables. Modified Poisson regression models were used to estimate prevalence proportion ratios (PPRs).

Results There were 1835 (955 gynecology, 880 urogynecology) patients included. Median age was 47 years (interquartile range, 29 years), and median body mass index was 28.15 kg/m2 (interquartile range, 9.96 kg/m2). Prevalence of opioid use was lowest among women who identified as Asian or other race and highest among black and Native American women; however, when compared by ethnicity, use was lowest among Hispanic women (P = 0.01). Among new urogynecology patients, 14% had self-reported opioid pain medication usage. Opioid use was almost twice as likely in the urogynecology group (PPR, 1.86; 95% confidence interval, 1.4–2.4). When adjusted for confounders, the urogynecology group was 1.3 times as likely to report opioid use (PPR 1.29; 95% confidence interval, 1.0–1.8), with this result approaching statistical significance.

Conclusions Opioid use is greater in patients presenting to the urogynecology clinic compared with general gynecology. Urogynecologists need to know this information for planning and optimizing pain management in this population.

From the *Obstetrics & Gynecology, Division of Female Pelvic Medicine & Reconstructive Surgery, University of Oklahoma Health Sciences Center;

School of Medicine, University of Oklahoma; and

Obstetrics & Gynecology and

§Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK.

Correspondence: Denicia S. Dwarica, MD, University of Oklahoma, 800 Stanton L. Young Blvd, Oklahoma City, OK 73104. E-mail: Denicia-Dwarica@ouhsc.edu.

The National Institutes of Health, National Institute of General Medical Sciences (grant 1 U54GM104938) for statistical support, provided funding.

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