Objective: Up to one in five patients with axial spondyloarthritis (AxSpA) or psoriatic arthritis (PsA) newly initiated on opioids transition to long-term use within the first year. This study aimed to investigate individual factors associated with long-term opioid use among opioid new users with AxSpA/PsA.
Methods: Adult patients with AxSpA/PsA and without prior cancer who initiated opioids between 2006-2021 were included from Clinical Practice Research Datalink Gold, a national UK primary care database. Long-term opioid use was defined as having ≥3 opioid prescriptions issued within 90 days, or ≥ 90 days of opioid supply, in the first year of follow-up. Individual factors assessed included sociodemographic, lifestyle factors, medication use and comorbidities. A mixed-effects logistic regression model with patient-level random intercept was used to examine the association of individual characteristics with the odds of long-term opioid use.
Results: In total 10 300 opioid initiations were identified from 8,212 patients (3037 AxSpA; 5175 PsA). The following factors were associated with long-term opioid use: being a current smoker (OR : 1.62; 95%CI : 1.38,1.90), substance use disorder (OR : 2.34, 95%CI : 1.05,5.21), history of suicide/self-harm (OR : 1.84; 95%CI : 1.13,2.99), co-existing fibromyalgia (OR : 1.62; 95%CI : 1.11,2.37), higher Charlson Comorbidity Index (OR : 3.61; 95%CI : 1.69,7.71 for high scores), high MME/day at initiation (OR : 1.03; 95%CI : 1.02,1.03) and gabapentinoid (OR : 2.35; 95%CI : 1.75,3.16) and antidepressant use (OR : 1.69; 95%CI : 1.45,1.98).
Conclusions: In AxSpA/PsA patients requiring pain relief, awareness of lifestyle, sociodemographic and prescribing characteristics associated with higher risk of long-term opioid use can prompt timely interventions such as structured medication reviews and smoking cessation to promote safer prescribing and better patient outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/rheumatology/keae444 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Background: The long-term impact of opioid use disorder (OUD) on brain health has been little explored although of potentially high public health importance.
Objectives: To investigate the potential causal impact of OUD on later life brain health outcomes, including dementia, stroke and brain structure.
Methods: Observational and Mendelian randomization (MR) analyses were conducted.
Long-term prescription opioid use following surgery in the US (2017-2022): a population-based study.
Lancet Reg Health Am
December 2024
Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Background: Over the last decade, numerous efforts have been made to combat the opioid crisis globally. The impact of these strategies has not been adequately measured and may differ across populations depending on baseline risk. We compared changes in long-term prescription opioid use following surgery within a national US cohort, between 2017 and 2022.
View Article and Find Full Text PDFIntraosseous basivertebral nerve ablation: A 5-year pooled analysis from three prospective clinical trials.
Interv Pain Med
December 2024
Department of Orthopaedic Surgery, William Beaumont University Hospital, 3811 West 13 Mile Rd, Royal Oak, MI, USA.
Article Synopsis
- Vertebrogenic pain, often linked to damage in vertebral endplates, is transmitted through the basivertebral nerve (BVN) and is associated with Modic changes visible on MRI.
- A five-year follow-up of three clinical trials assessing intraosseous radiofrequency ablation (BVNA) shows significant pain and functional improvement in patients with chronic low back pain.
- Out of 320 participants, 249 (78%) completed the study, revealing major reductions in pain scores and enhancements in disability index, demonstrating BVNA as an effective treatment option.
Intrathecal Drug Delivery for Intractable Pain: Identified Patient Satisfaction Survey Study Comparing Intrathecal Dose With Satisfaction, Pain Relief, and Side Effects.
Neuromodulation
January 2025
Department of Anesthesiology, University of Wisconsin, Madison, WI, USA.
Objectives: Past studies have shown the efficacy of spinal targeted drug delivery (TDD) in pain relief, reduction in opioid use, and cost-effectiveness in long-term management of complex chronic pain. We conducted a survey to determine treatment variables associated with patient satisfaction.
Materials And Methods: Patients in a single pain clinic who were implanted with Medtronic pain pumps to relieve intractable pain were identified from our electronic health record.
Efficacy of Transversus Thoracic Plane Block for Pain Management in Cardiac Surgeries.
Curr Pain Headache Rep
January 2025
Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA.
Purpose Of Review: Effective pain management in cardiac surgery presents as a continuous challenge related to the intensity of postoperative pain and reliance on opioid therapy. The dependance of opioid-based therapies is concerning, as these therapies carry risk future addiction and potential severe side effects. The transversus thoracic plane block (TTPB) has emerged as a promising regional anesthesia technique that blocks the anterior branches of the intercostal nerves in the chest wall, potentially providing improved analgesia for cardiac surgery patients.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!