Opioid tolerance and urine drug testing among initiates of extended-release or long-acting opioids in Food and Drug Administration's Sentinel System
| Autor: | Marc R, Larochelle, Noelle M, Cocoros, Jennifer, Popovic, Elizabeth C, Dee, Cynthia, Kornegay, Jing, Ju, Judith A, Racoosin |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Adolescent Databases Factual Inappropriate Prescribing Urinalysis Drug Prescriptions Young Adult Predictive Value of Tests Electronic Health Records Humans Practice Patterns Physicians' Child Retrospective Studies United States Food and Drug Administration Infant Newborn Infant Drug Tolerance Middle Aged United States Analgesics Opioid Child Preschool Delayed-Action Preparations Prescription Drug Monitoring Programs Female Chronic Pain Drug Monitoring Sentinel Surveillance |
| Zdroj: | Journal of opioid management. 13(5) |
| ISSN: | 1551-7489 |
| Popis: | A risk evaluation and mitigation strategy for extended-release and long-acting (ER/LA) opioid analgesics was approved by the Food and Drug Administration in 2012. Our objective was to assess frequency of opioid tolerance and urine drug testing for individuals initiating ER/LA opioid analgesics.Retrospective cohort study.Sentinel, a distributed database with electronic healthcare data on190 million predominantly commercially insured members.Members under age 65 initiating ER/LA opioid analgesics between January 2009 and December 2013.We examined the proportion of opioid-tolerant-only ER/LA opioid analgesic initiates meeting tolerance criteria: receipt of ≥30 mg oxycodone equivalents per day in 7 days prior to the first opioid-tolerant-only dispensing. We separately examined the proportion of new users of extended-release oxycodone (ERO) and other ER/LA opioid analgesics with a claim for a urine drug test in the 30 days prior to, and separately for the 183 days after, dispensing.We identified 79,824 ERO, 7,343 extended-release hydromorphone, and 91,778 transdermal fentanyl opi-oid-tolerant-only episodes. Tolerance criteria were met in 64 percent of ERO, 64 percent of extended-release hydromorphone and 40 percent of transdermal fentanyl episodes. We identified 210,581 incident ERO and 311,660 other ER/LA opioid analgesic episodes. Use of urine drug testing for ERO compared with other ER/LA opioid analgesics was: 4 percent vs 14 percent respectively in the 30 days prior to initiation and 9 percent vs 23 percent respectively in the 183 days following initiation.These results suggest potential areas for improving appropriate ER/LA opioid analgesic prescribing practices. |
| Databáze: | OpenAIRE |
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