Persistent Opioid Use Among the Elderly After Lung Resection: A SEER-Medicare Study

Abstract

Background. Opioids represent the mainstay for treating postsurgical pain but can cause significant morbidity in addition to dependency. The aim of the study was to determine the incidence of persistent opioid use after lung surgery. Methods. Patients who underwent lung resection from 2008 to 2013 for non-small cell lung cancer were identified in the Surveillance, Epidemiology and End Results-Medicare database. Patients were categorized as being chronic, intermittent, or naïve preoperative opioid users using information obtained from part D records. Persistent opioid use was defined as having a filled opioid prescription between 3 and 6 months after lung resection. Results. A total of 6948 patients were identified, among whom 3946 (56.8%) were opioid naïve, 2017 (29.0%) were intermittent opioid users, and 985 (14.2%) were chronic opioid users preoperatively. Persistent opioid use (3-6 months) after lung resection was high (31%), even among Patients and Methods Data Source The Surveillance, Epidemiology and End Results (SEER)-Medicare linked database was queried to identify the cohort for this study. 12 The SEER database maintains

Postoperative opioid use after lobectomy for primary lung cancer: A propensity-matched analysis of Premier hospital data

“…After propensity score matching, open pulmonary resection was associated with a nearly 50% greater likelihood of long-term opioid use, defined as >90 days postoperatively, compared with a VATS approach. In another recent Surveillance, Epidemiology, and End Results-Medicare analysis by Nelson and colleagues, 27 VATS was again identified as associated with less persistent opioid use compared to open surgery. Robotic cases were not included in either analysis.…”

Prevalence and distribution of high‐risk prescription opioid use in the United States, 2011–2016

“…6 These findings underscore the importance of further work to identify why these older populations seem to not have experienced the same magnitude of decrease in high-risk use that younger populations did. 4,26,27 The persistent equal prevalence of high-risk opioid use among males and females is noteworthy. Throughout the opioid epidemic,…”

Enhanced Recovery after Thoracic Surgery

“…27,28 After thoracic procedures, both open and minimally invasive, the rate is substantially higher-in fact higher than any other elective procedures-reported at 6 to 31%. [27][28][29][30] This is based on previously naïve patients filling opioid prescriptions 90 days or more after the procedure, when they should be fully recovered from surgery. As we shine a light on opioid abuse in recent years, this is increasingly concerning and compels action to address this problem-for the patients themselves as well as the flow of opioids into the community that results.…”