The association between severity of depression and prescription opioid misuse among chronic pain patients with and without anxiety: A cross-sectional study

Feingold, Daniel L.; Brill, Silviu; Goor‐Aryeh, Itay; Delayahu, Yael; Lev‐Ran, Shaul

doi:10.1016/j.jad.2018.04.058

Cited by 58 publications

(41 citation statements)

References 78 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other comorbidities, listed in table 2, included eight mental health conditions and a condition comprising chronic pain, fibromyalgia and fatigue. The latter conditions were included based on prior studies that have reported an association between such conditions and opioid use16 17 and their specifications were based on the Centers for Medicare and Medicaid Services Chronic Conditions Data Warehouse 18…”

Section: Methodsmentioning

confidence: 99%

Observational retrospective study of the association of initial healthcare provider for new-onset low back pain with early and long-term opioid use

et al. 2019

View full text Add to dashboard Cite

ObjectiveThis study examined the association of initial provider treatment with early and long-term opioid use in a national sample of patients with new-onset low back pain (LBP).DesignA retrospective cohort study of patients with new-onset LBP from 2008 to 2013.SettingThe study evaluated outpatient and inpatient claims from patient visits, pharmacy claims and inpatient and outpatient procedures with initial providers seen for new-onset LBP.Participants216 504 individuals aged 18 years or older across the USA who were diagnosed with new-onset LBP and were opioid-naïve were included. Participants had commercial or Medicare Advantage insurance.ExposuresThe primary independent variable is type of initial healthcare provider including physicians and conservative therapists (physical therapists, chiropractors, acupuncturists).Main outcome measuresShort-term opioid use (within 30 days of the index visit) following new LBP visit and long-term opioid use (starting within 60 days of the index date and either 120 or more days’ supply of opioids over 12 months, or 90 days or more supply of opioids and 10 or more opioid prescriptions over 12 months).ResultsShort-term use of opioids was 22%. Patients who received initial treatment from chiropractors or physical therapists had decreased odds of short-term and long-term opioid use compared with those who received initial treatment from primary care physicians (PCPs) (adjusted OR (AOR) (95% CI) 0.10 (0.09 to 0.10) and 0.15 (0.13 to 0.17), respectively). Compared with PCP visits, initial chiropractic and physical therapy also were associated with decreased odds of long-term opioid use in a propensity score matched sample (AOR (95% CI) 0.21 (0.16 to 0.27) and 0.29 (0.12 to 0.69), respectively).ConclusionsInitial visits to chiropractors or physical therapists is associated with substantially decreased early and long-term use of opioids. Incentivising use of conservative therapists may be a strategy to reduce risks of early and long-term opioid use.

show abstract

Section: Methodsmentioning

confidence: 99%

Observational retrospective study of the association of initial healthcare provider for new-onset low back pain with early and long-term opioid use

et al. 2019

View full text Add to dashboard Cite

show abstract

“…A total score of 10 or higher on the PHQ-9 was used to define the presence of depressive symptoms 19. In previous studies, the PHQ-9 questionnaire was often used to monitor depressive symptoms in patients with chronic pain 20 21. The PHQ-9 items are based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders and designed to ask about symptoms that relate to depression over the last 2 weeks.…”

Section: Methodsmentioning

confidence: 99%

Association between severity of depressive symptoms and chronic knee pain in Korean adults aged over 50 years: a cross-sectional study using nationally representative data

Han

Lee

et al. 2019

BMJ Open

View full text Add to dashboard Cite

ObjectivesTo identify the association between the presence and severity of depressive symptoms and those of chronic knee pain.DesignA retrospective cross-sectional study.ParticipantsWe used data from the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-2) performed in 2014. Overall, 7550 patients were included in the KNHANES VI-2.Outcome measuresParticipants were asked whether they had chronic knee pain, and each answer was either ‘yes’ or ‘no’. Patient Health Questionnaire-9 (PHQ-9) was used as a screening tool for depressive symptoms, and PHQ-9 scores of 10 or higher was classified as the depressed group. In total, 527 patients reported that they had pain in their knee, of whom 91 also had depressive symptoms.ResultsThe prevalence of chronic knee pain in the Korean population aged over 50 years was 19.8%. Multiple logistic regression was conducted after adjustment for sex, age, smoking, alcohol drinking, education level, household income, physical activity, sleep duration and comorbidity. The analysis revealed a significant association between depressive symptoms and chronic knee pain (adjusted OR=2.333, p<0.001). In contrast, the severity of depressive symptoms was linearly correlated with the intensity of chronic knee pain (p for trend <0.001). In participants with no chronic knee pain (Numerical Rating Scale; NRS=0) or mild chronic knee pain (NRS=1–4), the prevalence of moderate and severe depressive symptoms was 3.4% and 0.6%, respectively. However, in those with severe chronic knee pain (NRS=8–10), there was a higher prevalence of moderate and severe depressive symptoms (10.1% and 5.8%, respectively) (p<0.001).ConclusionsA strong association was observed between the presence and severity of depressive symptoms and the presence of chronic knee pain. The association became stronger with higher levels of depressive symptoms, indicating a positive correlation between depressive symptoms severity and chronic knee pain.

show abstract

“…To date, the most recent clinical recommendations from both Canada and the US (based on the best-available evidence) [14,15] report that there is limited evidence on cannabis' efficacy in improving depression symptoms. Importantly, few studies have directly studied the effect of medical cannabis solely on depression [16][17][18][19]. Rather, the majority of studies categorize depression under the broad category of mental health outcomes [5,20,21].…”

Section: Introductionmentioning

confidence: 99%

Changes in patient health questionnaire (PHQ-9) scores in adults with medical authorization for cannabis

et al. 2020

View full text Add to dashboard Cite

Background: Legal access to medical cannabis is increasing worldwide. Despite this, there is a lack of evidence surrounding its efficacy on mental health outcomes, particularly, on depression. This study assesses the effect of medical cannabis on Patient Health Questionnaire (PHQ-9) scores in adult patients between 2014 and 2019 in Ontario and Alberta, Canada. Methods: An observational cohort study of medically authorized cannabis patients in Ontario and Alberta. Overall change in PHQ-9 scores from baseline to follow-up were evaluated (mean change) over a time period of up to 3.2 years. Results: 37,338 patients from the cohort had an initial PHQ-9 score recorded with 5103 (13.7%) patients having follow-up PHQ-9 scores. The average age was 54 yrs. (SD 15.7), 46% male, 50% noted depression at baseline. The average PHQ-9 score at baseline was 10.5 (SD 6.9), following a median follow-up time of 196 days (IQR: 77-451) the average final PHQ-9 score was 10.3 (SD 6.8) with a mean change of − 0.20 (95% CI: − 0.26, − 0.14, p-value < 0.0001). Overall, 4855 (95.1%) had no clinically significant change in their PHQ-9 score following medical cannabis use while 172 (3.4%) reported improvement and 76 (1.5%) reported worsening of their depression symptoms. Conclusions: Although the majority showed no clinically important changes in PHQ-9 scores, a number of patients showed improvement or deteriorations in PHQ-9 scores. Future studies should focus on the parallel use of screening questionnaires to control for PHQ-9 sensitivity and to explore potential factors that may have attributed to the improvement in scores pre-and post-3-6 month time period.

show abstract

The association between severity of depression and prescription opioid misuse among chronic pain patients with and without anxiety: A cross-sectional study

Cited by 58 publications

References 78 publications

Observational retrospective study of the association of initial healthcare provider for new-onset low back pain with early and long-term opioid use

Observational retrospective study of the association of initial healthcare provider for new-onset low back pain with early and long-term opioid use

Association between severity of depressive symptoms and chronic knee pain in Korean adults aged over 50 years: a cross-sectional study using nationally representative data

Changes in patient health questionnaire (PHQ-9) scores in adults with medical authorization for cannabis

Contact Info

Product

Resources

About