Persistence with opioid treatment in Germany in patients suffering from chronic non-malignant or cancer pain

Kostev, Karel; Wartenberg, F; Richter, Hartmut; Reinwald, M; Heilmaier, Christina

doi:10.1185/03007995.2015.1034095

Cited by 11 publications

(5 citation statements)

References 51 publications

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“… 14 , 16 , 17 After 36 months of follow-up, treatment adherence was low (21.0%). Kostev et al found that in a large cohort of patients (n=32,158) with chronic pain, 32 adherence to opioids was low; 69% of patients discontinued treatment per year of follow up, similar to our study (64%). In the series analyzed in this research, opioid use did not result in a substantial reduction in pain and had no direct effect in reducing days of sick leave.…”

Section: Discussionsupporting

confidence: 89%

Sick Leave and Costs in Active Workers with Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study

Sicras‐Mainar¹,

Tornero-Tornero

Negrín³

et al. 2022

OARRR

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ObjectiveTo evaluate sick leave and its costs in active workers who initiate opioid treatment for moderate/severe chronic osteoarthritis (OA) pain. MethodsSecondary analysis of the longitudinal, retrospective OPIOIDS study using electronic medical records (EMR) of patients aged ≥ 18 years who started opioid treatment for chronic OA pain between 2010 and 2015 after treatment failure with usual analgesics. The follow-up period was 36 months from the index date, and the days of sick leave and their cost were analyzed. ResultsA total of 5,089 EMRs of OA chronic pain patients aged 56.8 years (SD: 4.6), 56.6% male, were analyzed: 73.3% of patients started treatment with a weak opioid and 26.7% a strong opioid. At 36 months, adherence was 21% (strong opioids 15.4%, weak opioids: 23%; p<0.001), and 77% of patients had at least one sick leave related with OA chronic pain, with a mean total days off work of 93 days in all actively working patients (120.5 days in patients with sick leaves). In 16.9% it lasted ≥ 6 months. Pain reduction was modest (-1.2 points; -4.0%, p<0.001). The cost of sick leave was € 2,594 patient/year and was associated (p<0.05) with age (β-0.043), female sex (β-0.035), comorbidity (β-0.034) and strong opioid use (β-0.037). ConclusionsActive workers who started opioid treatment for chronic osteoarthritis pain showed an increased frequency of sick leave and cost to society, with modest pain reduction. Age, female sex, comorbidity, and strong opioids were factors associated with the cost of sick leave.

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Section: Discussionsupporting

confidence: 89%

Sick Leave and Costs in Active Workers with Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study

Sicras‐Mainar¹,

Tornero-Tornero

Negrín³

et al. 2022

OARRR

View full text Add to dashboard Cite

show abstract

“…After 36 months of follow up, treatment adherence was low (21%). Kostev found that in a large cohort of patients (n=32,158) with chronic pain [30], adherence to opioids was low; 69% of patients discontinued treatment per year of follow up, similar to our study (64%). In the series analyzed in this research, opioid use did not result in a substantial reduction in pain and had no direct effect in reducing days of sick leave.…”

Section: Discussionsupporting

confidence: 88%

Sick Leave and Costs in Active Workers With Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study

Sicras‐Mainar

Tornero

Vargas

et al. 2020

Preprint

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ObjectiveTo evaluate sick leave and its costs in active workers who initiate opioid treatment for moderate/severe chronic osteoarthritis (OA) pain.MethodsSecondary analysis of the longitudinal, retrospective OPIOIDS study using electronic medical records (EMR) of patients aged ≥ 18 years who started opioid treatment for chronic OA pain between 2010 and 2015 after treatment failure with usual analgesics. The follow-up period was 36 months from the index date, and the days of sick leave and their cost were analyzed.ResultsA total of 5,089 EMRs of OA chronic pain patients aged 56.8 years (SD: 4.6), 56.6% male, were analyzed: 73.3% of patients started treatment with a weak opioid and 26.7% a strong opioid. At 36 months, adherence was 21% (strong opioids 15.4%, weak opioids: 23%; p<0.001), and 77% of patients had at least one sick leave related with OA chronic pain, with a mean total days off work of 93 days in all actively working patients (120.5 days in patients with sick leaves). In 16.9% it lasted ≥ 6 months. Pain reduction was modest (-1.2 points; -4.0%, p<0.001). The cost of sick leave was € 2,594 patient/year and was associated (p<0.05) with age (β-0.043), female sex (β-0.035), comorbidity (β-0.034) and strong opioid use (β-0.037).ConclusionsActive workers who started opioid treatment for chronic osteoarthritis pain showed an increased frequency of sick leave and cost to society, with modest pain reduction. Age, female sex, comorbidity, and strong opioids were factors associated with the cost of sick leave.

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“…Kostev et al evaluated the persistence of opioids in a large cohort of patients ( n = 32,158) who were treated for chronic pain. 35 As of the following year, 69.0% had discontinued medication. The authors concluded that adherence to opioids was associated with chronic comorbidity and depression, whereas younger subjects with chronic noncancerous pain (back osteoarthritis) increased the likelihood of opioid discontinuation.…”

Section: Discussionmentioning

confidence: 99%

Health outcomes and costs in patients with osteoarthritis and chronic pain treated with opioids in Spain: the OPIOIDS real-world study

Sicras‐Mainar¹,

Tornero-Tornero

Negrín³

et al. 2020

Therapeutic Advances in Musculoskeletal

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Objective: The objective of this study was to analyze health outcomes, resource utilization, and costs in osteoarthritis patients with chronic nociceptive pain who began treatment with an opioid in real-world practice in Spain. Methods: We designed a non-interventional, retrospective, longitudinal study with 36 months of follow-up using electronic medical records (EMRs) from primary care centers, of patients aged 18+ years who began a new treatment with an opioid drug in usual practice for chronic pain due to osteoarthritis. Health/non-health resource utilization and costs, treatment adherence, pain change, cognitive functioning, and dependence for basic activities of daily living (BADL) were assessed. Results: A total of 38,539 EMRs [mean age (SD); 70.8 (14.3) years, 72.3% female; 53.3% hip/knee, 25.0% spine, and 21.7% other sites] were recruited. A total of 19.1% of patients remained on initial opioid at 36 months, without significant differences by osteoarthritis site ( p = 0.125). Mean total adjusted cost was €17,915, with 27.7% corresponding to healthcare resources and 72.3% to lost productivity. Hospital admissions for osteoarthritis-related surgical interventions accounted for 15.8% of total healthcare cost. A slight mean pain reduction was observed: –1.3 points, –16.9%, p < 0.001, with increases in cognitive deficit (+3.3%, p < 0.001) and moderate to total dependence for BADL (+15.6%, p < 0.001) in a median duration of opioid use of 203 days (IQR: 89–696). Conclusions: In real-world practice in Spain, opioid use in osteoarthritis was high, but with low adherence. There were meaningful increases in resource use and costs for the National Health System. Pain reduction was modest, whereas cognitive impairment and dependence for BADL increased significantly.

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Persistence with opioid treatment in Germany in patients suffering from chronic non-malignant or cancer pain

Cited by 11 publications

References 51 publications

Sick Leave and Costs in Active Workers with Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study

Sick Leave and Costs in Active Workers with Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study

Sick Leave and Costs in Active Workers With Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study

Health outcomes and costs in patients with osteoarthritis and chronic pain treated with opioids in Spain: the OPIOIDS real-world study

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