Impact of opioid use on health care utilization and survival in patients with newly diagnosed stage IV malignancies

Impact of opioid use on health care utilization and survival in patients with newly diagnosed... Purpose Patients with advanced cancers frequently experience pain. Opioids are commonly prescribed to treat cancer-related pain, but their use might be associated with undesirable consequences including adverse effects and tumor progression, resulting in increased heath care utilization and shorter survival. We examined these possibilities in a large cohort of patients diagnosed with ten common advanced malignancies. Methods We identified 1386 newly diagnosed patients with stage IV non-hematologic malignancies from 2005 to 2013 and ascertained opioid utilization within 90 days of starting anti-cancer treatment using electronic medical record and tumor registry data. Opioid utilization was stratified into low opioid (LO; < 5 mg oral morphine equivalents (OME)/day) and high opioid (HO; ≥ 5 mg OME/day). Health care utilization included tallies of emergency room, urgent care, and inpatient visits. The association of opioid use, tumor type prognosis, age, and gender with overall survival was analyzed in univariate and multivariate models. Results HO use patients (n = 624) had greater health care utilization compared to LO use patients (n = 762; p <0.05). HO use patients also had shorter survival (median survival, 5.5 vs 12.4 months; p < 0.0001). On multivariate analysis, HO use remained associated with shorter overall survival (HR 1.4; http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Supportive Care in Cancer Springer Journals

Impact of opioid use on health care utilization and survival in patients with newly diagnosed stage IV malignancies

8 pages
Read Article

Loading next page...
 
/lp/springer_journal/impact-of-opioid-use-on-health-care-utilization-and-survival-in-XCHuNMpx9L
Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer-Verlag GmbH Germany, part of Springer Nature
Subject
Medicine & Public Health; Oncology; Nursing; Nursing Research; Pain Medicine; Rehabilitation Medicine
ISSN
0941-4355
eISSN
1433-7339
DOI
10.1007/s00520-018-4062-z
Publisher site
See Article on Publisher Site

Abstract

Purpose Patients with advanced cancers frequently experience pain. Opioids are commonly prescribed to treat cancer-related pain, but their use might be associated with undesirable consequences including adverse effects and tumor progression, resulting in increased heath care utilization and shorter survival. We examined these possibilities in a large cohort of patients diagnosed with ten common advanced malignancies. Methods We identified 1386 newly diagnosed patients with stage IV non-hematologic malignancies from 2005 to 2013 and ascertained opioid utilization within 90 days of starting anti-cancer treatment using electronic medical record and tumor registry data. Opioid utilization was stratified into low opioid (LO; < 5 mg oral morphine equivalents (OME)/day) and high opioid (HO; ≥ 5 mg OME/day). Health care utilization included tallies of emergency room, urgent care, and inpatient visits. The association of opioid use, tumor type prognosis, age, and gender with overall survival was analyzed in univariate and multivariate models. Results HO use patients (n = 624) had greater health care utilization compared to LO use patients (n = 762; p <0.05). HO use patients also had shorter survival (median survival, 5.5 vs 12.4 months; p < 0.0001). On multivariate analysis, HO use remained associated with shorter overall survival (HR 1.4;

Journal

Supportive Care in Cancer – Springer Journals

Published: Feb 2, 2018

References

  • Principles of opioid use in cancer pain
    Portenoy, RK; Ahmed, E
  • Prevalence of pain in patients with cancer: a systematic review of the past 40 years
    Beuken-van Everdingen, MH
  • Access to opioid analgesics and pain relief for patients with cancer
    Dalal, S; Bruera, E
  • Opioid complications and side effects
    Benyamin, R; Trescot, AM; Datta, S; Buenaventura, R; Adlaka, R; Sehgal, N; Glaser, SE; Vallejo, R
  • Lung cancer patients frequently visit the emergency room for cancer-related and -unrelated issues
    Kotajima, F
  • Increases in drug and opioid-involved overdose deaths—United States, 2010-2015
    Rudd, RA; Seth, P; David, F; Scholl, L
  • Societal costs of prescription opioid abuse, dependence, and misuse in the United States
    Birnbaum, HG; White, AG; Schiller, M; Waldman, T; Cleveland, JM; Roland, CL
  • Is regular systemic opioid analgesia associated with shorter survival in adult patients with cancer? A systematic literature review
    Boland, JW; Ziegler, L; Boland, EG; McDermid, K; Bennett, MI
  • The role of opioids in cancer progression: emerging experimental and clinical implications
    Sjogren, P; Kaasa, S
  • Opioid requirement, opioid receptor expression, and clinical outcomes in patients with advanced prostate cancer
    Zylla, D; Gourley, BL; Vang, D; Jackson, S; Boatman, S; Lindgren, B; Kuskowski, MA; Le, C; Gupta, K; Gupta, P
  • Association of opioid requirement and cancer pain with survival in advanced non-small cell lung cancer
    Zylla, D; Kuskowski, MA; Gupta, K; Gupta, P
  • Clinical application of opioid equianalgesic data
    Gammaitoni, AR; Fine, P; Alvarez, N; McPherson, ML; Bergmark, S
  • Treatment patterns, healthcare utilization, and costs of chronic opioid treatment for non-cancer pain in the United States
    Kern, DM; Zhou, S; Chavoshi, S; Tunceli, O; Sostek, M; Singer, J; LoCasale, RJ
  • Pain predicts overall survival in men with metastatic castration-refractory prostate cancer
    Halabi, S; Vogelzang, NJ; Kornblith, AB; Ou, SS; Kantoff, PW; Dawson, NA; Small, EJ
  • COX-2 inhibitor celecoxib prevents chronic morphine-induced promotion of angiogenesis, tumour growth, metastasis and mortality, without compromising analgesia
    Farooqui, M; Li, Y; Rogers, T; Poonawala, T; Griffin, RJ; Song, CW; Gupta, K
  • Morphine stimulates angiogenesis by activating proangiogenic and survival-promoting signaling and promotes breast tumor growth
    Gupta, K; Kshirsagar, S; Chang, L; Schwartz, R; Law, PY; Yee, D; Hebbel, RP
  • The novel role of the mu opioid receptor in lung cancer progression: a laboratory investigation
    Mathew, B; Lennon, FE; Siegler, J; Mirzapoiazova, T; Mambetsariev, N; Sammani, S; Gerhold, LM; LaRiviere, PJ; Chen, CT; Garcia, JGN; Salgia, R; Moss, J; Singleton, PA
  • Increased mu-opioid receptor expression in metastatic lung cancer
    Singleton, PA; Mirzapoiazova, T; Hasina, R; Salgia, R; Moss, J
  • mu-Opioid receptor gene A118G polymorphism predicts survival in patients with breast cancer
    Bortsov, AV; Millikan, RC; Belfer, I; Boortz-Marx, RL; Arora, H; McLean, SA
  • The mu opioid receptor: a new target for cancer therapy?
    Singleton, PA; Moss, J; Karp, DD; Atkins, JT; Janku, F
  • Treatment with methylnaltrexone is associated with increased survival in patients with advanced cancer
    Janku, F; Johnson, LK; Karp, DD; Atkins, JT; Singleton, PA; Moss, J
  • Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain
    Boehnke, KF; Litinas, E; Clauw, DJ
  • Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studies
    Fallon, MT; Albert Lux, E; McQuade, R; Rossetti, S; Sanchez, R; Sun, W; Wright, S; Lichtman, AH; Kornyeyeva, E
  • The effect of medicinal cannabis on pain and quality-of-life outcomes in chronic pain: a prospective open-label study
    Haroutounian, S; Ratz, Y; Ginosar, Y; Furmanov, K; Saifi, F; Meidan, R; Davidson, E

You’re reading a free preview. Subscribe to read the entire article.

Try 2 weeks free now

DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

or browse the journals available

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create folders to
organize your research

Export folders, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off

Sign up
for free
Start 14 day
Free Trial