Article

OBJECTIVES: To (1) compare the opioid utilization patterns in opioid users with
spinal cord injury (SCI) to a propensity score-matched general population of
opioid users without SCI; and (2) identify characteristics of persons with SCI
associated with long-term and/or high-dose use of opioids. DESIGN: Quasi-experimental analysis of archival data. SETTING: Data used for the analysis
were derived from Thompson Reuters MarketScan Commercial Claims and Encounters
Databases for the years 2012 to 2013. PARTICIPANTS: Participants (N=2908; aged
18-64y) included opioid users with SCI (n=1454) and propensity score-matched
opioid users without SCI (n=1454). The cohorts were matched using demographics
including comorbidities, hospital admissions, age, sex, and geographic region.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Medical and pharmacy claims
from 2012 to 2013 MarketScan data were analyzed to characterize whether persons
were short-term (<90d) or long-term (>/=90d) opioid users, and whether persons
had high (>/=120mg) or low (<120mg) average daily morphine equivalents. RESULTS:
Persons with SCI were significantly more likely to be long-term users of
low-dose, short-acting opioids (P<.0001) and more likely to be taking high
morphine-equivalent doses of long-acting opioids (P<.0001) than matched controls.
Among persons with SCI, those with lumbar/sacral injuries had more days' supply
of high-dose, long-acting opioids than did persons with thoracic or cervical
injuries. CONCLUSIONS: Persons with SCI are prescribed opioids for longer
durations and at higher morphine-equivalent doses than controls, which may
increase the risk of opioid dependence or adverse drug events. Findings should be
considered in the development of practice guidelines for alternate pain
management options or opioid dependence interventions for persons with SCI.
CI - Published by Elsevier Inc.

Langue : ANGLAIS