Association Between Dual Trajectories of Opioid and Gabapentinoid Use and Healthcare Expenditures Among US Medicare Beneficiaries

Zhou, Lili; Bhattacharjee, Sandipan; Kwoh, C. Kent; Malone, Daniel C.; Tighe, Patrick J.; Reisfield, Gary M.; Slack, Marion; Wilson, Debbie L.; Lo-Ciganic, Wei Hsuan

doi:10.1016/j.jval.2020.12.001

Cited by 5 publications

(2 citation statements)

References 42 publications

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“…16,32 We included gabapentin as it is one of the most commonly added adjunctive analgesic medications for older adults. 33,34 The NPDS annual report also shows that after analgesics, CVD drugs, muscle relaxants, and psychotropic medications were the most frequently involved pharmaceuticals in adult exposures. 31 We did not include other medications as they were involved in a small proportion (<3%) of cases (eg, hypoglycemic medications involved in 1.1% of cases).…”

Section: Methodsmentioning

confidence: 99%

Polypharmacy and Healthcare Service Use Among Prescription Opioid Poisoning Cases Age 50+

Choi

DiNitto

et al. 2022

Journal of Pharmacy Practice

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Objectives: To examine relationships between polypharmacy and level of healthcare service use among prescription opioid poisoning cases age 50 and older. Methods: Data came from the American Association of Poison Control Center’s National Poison Data System, 2015-2020. We used multinomial logistic regression to examine the study questions. Results: Of the 77 946 cases with prescription opioid exposures, 64.5% were managed at a healthcare facility (HCF). Of HCF-managed cases, 41.2% were treated/evaluated and released and 21.3% and 37.5% were admitted for noncritical care and critical care, respectively. Medications for cardiovascular disease, benzodiazepines, other types of sedatives/hypnotics, antipsychotics, muscle relaxants, acetaminophen, and gabapentin were associated with increased risk of admission to both noncritical and critical care compared to treatment/evaluation and release. Acetaminophen use had the highest relative risk ratios (RRRs) for noncritical care (1.70, 95% CI = 1.51-1.91) and critical care (1.56, 95% CI = 1.39-1.76). Each additional medication/substance used was associated with 1.14 (95% CI = 1.11-1.17) and 1.19 (95% CI = 1.16-1.22) greater risk of noncritical and critical care admissions, respectively. Conclusions: Among older-adult poison control center cases for prescription opioid exposures, co-use of several commonly prescribed/used medicines was associated with increased risk of admissions to both noncritical and critical care units. Careful monitoring of medication use among older adults who use prescription opioids may reduce the risk of unintentional and intentional opioid poisoning.

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Section: Methodsmentioning

confidence: 99%

Polypharmacy and Healthcare Service Use Among Prescription Opioid Poisoning Cases Age 50+

Choi

DiNitto

et al. 2022

Journal of Pharmacy Practice

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“…9 Zhou et al provide evidence from Medicare claims data that illustrate the complexity of designing an appropriate regimen, where effectiveness and total cost of a treatment program is related to the level of initial opioid use and whether opioid agonists are used alone or in combination with gabapentinoids. 10 These studies collectively add to the understanding that there was a substantial delay in recognizing the crisis for what it might become, the difficulties of initiating both prevention and treatment responses, and some proposed solutions.…”

mentioning

confidence: 99%

Opioid Misuse: A Global Crisis

Hornberger

Chhatwal

2021

Value in Health

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Opioid poisoning cases aged 50+ in the 2015–2020 National Poisoning Data System: suspected suicides versus unintentional poisoning and other intentional misuse/abuse

Choi

DiNitto

et al. 2021

Drug and Chemical Toxicology

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Association Between Dual Trajectories of Opioid and Gabapentinoid Use and Healthcare Expenditures Among US Medicare Beneficiaries

Cited by 5 publications

References 42 publications

Polypharmacy and Healthcare Service Use Among Prescription Opioid Poisoning Cases Age 50+

Polypharmacy and Healthcare Service Use Among Prescription Opioid Poisoning Cases Age 50+

Opioid Misuse: A Global Crisis

Opioid poisoning cases aged 50+ in the 2015–2020 National Poisoning Data System: suspected suicides versus unintentional poisoning and other intentional misuse/abuse

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