Systemic Opioid Reduction and Discontinuation Following Implantation of Intrathecal Drug-Delivery Systems for Chronic Pain: A Retrospective Cohort Analysis
| Autor: | Christine I. Nichols-Ricker, John A. Hatheway, Megha Bansal |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Chronic pain pain control intrathecal analgesia 03 medical and health sciences drug delivery systems 0302 clinical medicine Pharmacotherapy Clinical Research Medicine Humans Aged Retrospective Studies Aged 80 and over business.industry Retrospective cohort study General Medicine Odds ratio Middle Aged medicine.disease Confidence interval Discontinuation Analgesics Opioid Anesthesiology and Pain Medicine Neurology Opioid prescription opioid drugs Anesthesia Morphine Female Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Neuromodulation |
| ISSN: | 1525-1403 |
| Popis: | OBJECTIVE The study evaluated systemic opioid utilization before and after initiation of intrathecal drug therapy in patients with chronic, noncancer pain, as well as the effect of opioid elimination on payer costs. METHODS This was a retrospective cohort analysis of administrative claims data (2011-2016), evaluating patients using systemic opioids for chronic, noncancer pain, newly implanted with an intrathecal drug-delivery system. Patients were excluded for spasticity, cancer, and device explant. The primary outcome was reduction or discontinuation of systemic morphine milligram equivalents during a 395-day follow-up period. The secondary outcome was total commercial insurer payments. RESULTS Of 9223 total patients, 631 met selection criteria. From baseline to 395-day follow-up, average daily morphine milligram equivalents decreased in 81.5% of patients, and 43.3% discontinued systemic opioid therapy entirely. Among patients who continued systemic opioids, average daily morphine milligram equivalents decreased in 74.9% of patients. Logistic regression found that morphine milligram equivalents of |
| Databáze: | OpenAIRE |
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