Starting Young: Trends in Opioid Therapy Among US Adolescents and Young Adults With Inflammatory Bowel Disease in the Truven MarketScan Database Between 2007 and 2015

Wren, Anava A.; Bensen, Rachel; Sceats, Lindsay A.; Dehghan, Melody; Yu, Helen; Wong, Jessie J.; MacIsaac, Donna; Sellers, Zachary M.; Kin, Cindy; Park, K T

doi:10.1093/ibd/izy222

Cited by 38 publications

(20 citation statements)

References 30 publications

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“…These are particularly promising findings as children and young adults with IBD are a high-risk population. Research has shown that children with IBD experience higher rates of psychiatric disorders compared to healthy children and those with other chronic illnesses [ 5 , 6 ], increasing rates of chronic abdominal pain and chronic opioid use [ 42 , 43 , 44 ], and lower quality of life [ 5 , 6 ], all of which can negatively impact emotional and physical functioning in adulthood. As a result, there has been an increased call for behavioral interventions to support psychological and physical wellbeing among children with IBD [ 6 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Mindfulness-Based Virtual Reality Intervention for Children and Young Adults with Inflammatory Bowel Disease: A Pilot Feasibility and Acceptability Study

et al. 2021

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The aim of this pilot study was to assess: (1) the feasibility and acceptability of a Mindfulness-Based Virtual Reality (MBVR) intervention among children and young adults with Inflammatory Bowel Disease (IBD), and (2) the preliminary efficacy of MBVR on key psychological (anxiety) and physical (pain) outcomes. Participants were 62 children to young adults with IBD (M = 15.6 years; 69.4% Crohn’s disease; 58% male) recruited from an outpatient pediatric IBD clinic. Participants completed a baseline assessment, underwent the 6-min MBVR intervention, completed a post-intervention assessment and study satisfaction survey, and provided qualitative feedback. Results suggest strong feasibility and acceptability. Participants reported high levels of satisfaction with MBVR including high levels of enjoyment (M = 4.38; range 1–5) and relaxation (M = 4.35; range 1–5). Qualitative data revealed several key themes including participants interest in using MBVR in IBD medical settings (e.g., hospitalizations, IBD procedures, IBD treatments), as well as in their daily lives to support stress and symptom management. Preliminary analyses demonstrated improvements in anxiety (t = 4.79, p = 0.001) and pain (t = 3.72, p < 0.001) following MBVR. These findings provide initial support for the feasibility and acceptability of MBVR among children and young adults with IBD. Results also suggest MBVR may improve key IBD outcomes (e.g., anxiety, pain) and highlight the importance of conducting a randomized controlled trial and more rigorous research to determine intervention efficacy.

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Section: Discussionmentioning

confidence: 99%

Mindfulness-Based Virtual Reality Intervention for Children and Young Adults with Inflammatory Bowel Disease: A Pilot Feasibility and Acceptability Study

et al. 2021

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“…Furthermore, and in line with former studies [21,22], the present study revealed increased postoperative overall morbidity and prolonged length of hospital stay in patients with Crohn's disease. Potential explanations for these findings include increased opioid use [23,24] and unfavourable baseline conditions with emergent or expedited procedures [25] in this particular subset of patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of recovery and outcome after left and right colectomy

et al. 2019

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Aim The present study aimed to compare functional recovery and surgical outcomes after left and right colectomies. Method Consecutive elective left and right colon resections for benign and malignant indications, performed between 2011 and 2016 and recorded in a prospectively maintained enhanced recovery database, were analysed. Demographic and surgical items, as well as functional recovery and 30‐day complications, were compared between left‐sided and right‐sided colectomies. Multivariable analysis was performed to identify risk factors for postoperative ileus (POI). Results In total, 1001 left and 1041 right colectomies were comparable regarding demographic factors; only body mass index (BMI) was higher in patients undergoing left‐sided resections (> 30 kg/m2: 33% vs 27%, P = 0.004). Malignancy (29% vs 67%, P < 0.001) and Crohn's disease (1% vs 31%, P < 0.001) were preponderant in right colectomies, whereas diverticular disease (68% vs 1%, P < 0.001) was the most common indication for left colectomy. Compliance with the enhanced recovery pathway (ERP) was comparable. While the minimally invasive approach was the preferred approach for both sides (61% vs 64%, P = 0.158), left colectomies took longer (180 ± 80 min vs 150 ± 70 min, P < 0.001), needed more perioperative fluids (3.1 ± 1.4 l vs 2.7 ± 1.5 l, P < 0.001) and resulted in greater postoperative weight gain (3.9 ± 6.5 kg vs 2.6 ± 6 kg, P = 0.025). Crohn's disease (OR = 2.64, 95% CI: 1.27–5.46) and fluid overload (OR = 2.02, 95% CI: 1.06–3.82) were independent risk factors for POI. Conclusion Despite equal ERP compliance, postoperative ileus was higher after right‐sided colectomies. This finding was associated with Crohn's disease and fluid overload.

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“…It has been well established that the prevalence of opioid use in IBD is rising, as it is the general United States population. 24 In a landmark paper, Targownik, et al investigated heavy opioid use in IBD patients and reported that individuals with IBD are 3 times more likely to become heavy opioid users compared with their matched controls. Heavy opioid use was also significantly associated with mortality.…”

Section: Discussionmentioning

confidence: 99%

Incidence and predictors of new persistent opioid use following inflammatory bowel disease flares treated with oral corticosteroids

Noureldin

Higgins

Govani

et al. 2018

Aliment Pharmacol Ther

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Summary Background Opioids are commonly prescribed to manage pain associated with inflammatory bowel disease (IBD). It is unknown what percentage of patients develop new persistent opioid use following a steroid‐treated IBD flare. Aim To identify the incidence and the predictors of new persistent opioid use following an IBD flare. Methods We used a national insurance claim dataset to identify patients with IBD who received an opioid medication around the time of a corticosteroid‐treated IBD flare. Patients were stratified as previously opioid naïve, intermittent users, or chronic users. The incidence of persistent opioid use among the opioid‐naïve cohort was evaluated along with associated predictors. Results We identified 15 119 IBD patients who received opioids around the time of a flare. 5411 (35.8%) were opioid‐naïve patients of which 35.0% developed persistent opioid use after the flare. Factors associated with new persistent opioid use include a history of depression (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.13‐1.47), substance abuse (HR 1.36, 95% CI 1.2‐1.54), chronic obstructive pulmonary disease (COPD) (HR 1.17, 95% CI 1.04‐1.3), as well as, Crohn's disease (HR 1.26, 95% CI 1.14‐1.4) or indeterminate colitis (HR 1.6, 95% CI 1.36‐1.88). Conclusions New persistent opioid use is common in IBD patients who experience a flare, especially among those with mental health disorders, COPD, and Crohn's disease or indeterminate colitis. These findings can be helpful in risk‐stratifying patients when choosing an acute pain therapy and providing counselling before choosing to prescribe opioids to opioid‐naïve patients experiencing an IBD flare.

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Starting Young: Trends in Opioid Therapy Among US Adolescents and Young Adults With Inflammatory Bowel Disease in the Truven MarketScan Database Between 2007 and 2015

Abstract: Sustained chronic opioid use in adolescents and young adults with IBD is increasingly common, underscoring the need for screening and intervention for this vulnerable population.

Cited by 38 publications

References 30 publications

Mindfulness-Based Virtual Reality Intervention for Children and Young Adults with Inflammatory Bowel Disease: A Pilot Feasibility and Acceptability Study

Mindfulness-Based Virtual Reality Intervention for Children and Young Adults with Inflammatory Bowel Disease: A Pilot Feasibility and Acceptability Study

Comparison of recovery and outcome after left and right colectomy

Incidence and predictors of new persistent opioid use following inflammatory bowel disease flares treated with oral corticosteroids

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