Comparative out‐of‐hospital mortality of long‐acting opioids prescribed for non‐cancer pain: A retrospective cohort study

Chung, Cecilia P.; Dupont, William D.; Murray, Katherine T.; Hall, Kathi; Stein, C. Michael; Ray, Wayne A.

doi:10.1002/pds.4619

Cited by 9 publications

(20 citation statements)

References 28 publications

(46 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 26 The risk of increased out-of-hospital mortality was higher in patients using morphine and fentanyl than in those using oxycodone in another cohort study of the same group. 175 Importantly, opioids (including tramadol) were demonstrated to cause higher risk of mortality among patients treated for chronic non-malignant pain than NSAIDs. 25 , 176 The risk of opioid-related death may be increased with the use of long-acting opioids, at a higher dose range, within 4 weeks after opioid initiation.…”

Section: Resultsmentioning

confidence: 99%

“…27 However, a number of individual epidemiological investigations published so far indicated that patients treated with opioids for chronic pain may be susceptible to a higher risk of injuries, poisoning and mortality. 25,26,132,[171][172][173][174][175][176][177][178][179][180] For example, in a trial concerning approximately 10,000 patients with chronic non-malignant pain treated with opioids, 51 cases of opioid overdose, including 6 (12%) opioidrelated deaths, were identified. Patients receiving ≥100 mg of MEDD had a 1.8% annual overdose rate.…”

Section: Dovepressmentioning

confidence: 99%

See 1 more Smart Citation

Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review

Kotlińska-Lemieszek

Żylicz

2022

DDDT

View full text Add to dashboard Cite

Background The adverse effects of short-term opioid analgesics are well known and acknowledged; however, the spectrum of the sequelae of long-term use seems less clear. Some effects may remain undetected but still have the potential to cause harm and reduce patients’ quality of life. Objective To review the literature on the adverse effects of long-term opioid therapy. Methods We performed a quasi-systematic search, analyzing articles published in the MEDLINE database between January 2000 and March 2021 that identified adverse effects of opioids used for chronic pain treatment. Results Growing evidence indicates that there are multiple serious adverse effects of opioid treatment. Long-term opioid use may have significant effects on the endocrine, immune, cardiovascular, respiratory, gastrointestinal, and neural systems. Studies show that long-term opioid treatment increases the risk of fractures, infections, cardiovascular complications, sleep-disordered breathing, bowel dysfunction, overdose, and mortality. Opioids may potentially affect cancer development. Most consequences of the long-term use of opioids have been identified in studies of patients with non-malignant pain. Conclusion Studies indicate that long-term use of opioids increases the risk of drug-related events in a significant number of patients. Clinicians should be aware of these complications associated with prescribing opioids, discuss them with patients, prevent complications, if possible, and diagnose them early and manage adequately. More human studies are needed to assess the risk, including trials with individual opioids, because they have different adverse effect profiles.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review

Kotlińska-Lemieszek

Żylicz

2022

DDDT

View full text Add to dashboard Cite

show abstract

“…The practice of data linkage for complete outcome ascertainment is well‐known to pharmacoepidemiologists following the guidelines for good pharmacoepidemiology practice . Recent work by Chung et al in TennCare data highlights the ascertainment of out‐of‐hospital death in an opioid study by linking to state‐specific computerized death certificate data. Data linkage is likely pivotal in a majority of our health system databases to identify outcomes, particularly for mortality.…”

Section: Introductionmentioning

confidence: 99%

Mortality: The final outcome

Haynes

2019

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

“…For instance, long-acting opioid use has been correlated with increased risk of serious infection, with patients given oxycodone demonstrating a lower rate of infection than those prescribed morphine (Wiese et al, 2018). Additionally, a large retrospective cohort study recently reported that the risk of outof-hospital death was lower in those filling long-acting oxycodone than in those filling long-acting morphine, potentially pointing to an association between type of opioid prescribed and subsequent mortality outcomes (Chung et al, 2019).…”

mentioning

confidence: 99%

Both Race and Insurance Type Independently Predict the Selection of Oral Opioids Prescribed to Cancer Outpatients

Meghani

Rosa

Chittams

et al. 2020

Pain Management Nursing

View full text Add to dashboard Cite

a b s t r a c tBackground: Previous research suggests that racial disparities in patients' reported analgesic adverse effects are partially mediated by the type of opioid prescribed to African Americans despite the presence of certain comorbidities, such as renal disease. Aims: We aimed to identify independent predictors of the type of opioid prescribed to cancer outpatients and determine if race and chronic kidney disease independently predict prescription type, adjusting for relevant sociodemographic and clinical confounders. Design: We conducted a secondary analysis of a 3-month observational study. Setting: Outpatient oncology clinics of an academic medical center. Participants/Subjects: Patients were older than 18 years of age, self-identified as African American or White, and had an analgesic prescription for cancer pain. Methods: Cancer patients (N ¼ 241) were recruited from outpatient oncology clinics within a large mid-Atlantic healthcare system. Results: Consistent with published literature, most patients (75.5%) were prescribed either morphine or oxycodone preparations as oral opioid therapy for cancer pain. When compared with Whites, African Americans were significantly more likely to be prescribed morphine (33% vs 14%) and less likely to be prescribed oxycodone (38% vs 64%) (p < .001). The estimated odds for African Americans to receive morphine were 2.573 times that for Whites (95% confidence interval 1.077-6.134) after controlling for insurance type, income, and pain levels. In addition, the presence of private health insurance was negatively associated with the prescription of morphine and positively associated with prescription of oxycodone in separate multivariable models. The presence of chronic kidney disease did not predict type of analgesic prescribed. Conclusions: Both race and insurance type independently predict type of opioid selection for cancer outpatients. Larger clinical studies are needed to fully understand the sources and clinical consequences of racial differences in opioid selection for cancer pain.

show abstract

Comparative out‐of‐hospital mortality of long‐acting opioids prescribed for non‐cancer pain: A retrospective cohort study

Cited by 9 publications

References 28 publications

Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review

Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review

Mortality: The final outcome

Both Race and Insurance Type Independently Predict the Selection of Oral Opioids Prescribed to Cancer Outpatients

Contact Info

Product

Resources

About