Journal article
Opioid use trajectories after thoracic surgery among veterans in the United States
European journal of pain, Vol.24(8), pp.1569-1584
09/2020
DOI: 10.1002/ejp.1610
PMID: 32506529
Abstract
Background
Opioid use has increased to epidemic levels over the past decade within the United States, particularly among vulnerable populations. This retrospective study aimed to evaluate rates of prolonged opioid use in the Veteran population after thoracic surgery and identify specific risk clusters.
Methods
Veterans Administration data on patients who underwent thoracic surgery between January 1, 2006 and September 30, 2015 included preoperative opioid use information for stratification of patients to preoperative chronic opioid use (PCOU; nPCOU = 16,612) versus patients without preoperative chronic opioid use (WPCOU; nWPCOU = 2,328). A Poisson regression model and prior literature were used to identify variables for use in a Latent Class Analysis (LCA) model for each stratum. Three‐cluster models were selected, and identified as ‘low‐’, ‘intermediate‐’ and ‘high‐’ risk groups.
Results
Cluster interpretations included: (a) Low risk: no psychiatric diagnoses, preoperative medication use, or preoperative chronic pain, (b) Intermediate risk: no psychiatric diagnoses, but had preoperative medication use and some preoperative chronic pain and (c) High risk: psychiatric diagnoses, preoperative medication use and preoperative chronic pain. For the PCOU stratum, rates of prolonged opioid use 1 year after surgery were as follows: 46.3%, 61.9% and 66.0%. For the WPCOU stratum, the observed rates were 4.7%, 8.3% and 9.2%.
Conclusions
Prolonged opioid use trajectories obviously differ by PCOU status, as well as preoperative psychosocial diagnoses, medication use and chronic pain. This is a first step in population‐level research to curb the rate of prolonged opioid use in Veterans following thoracic surgery.
Significance
This article presents population‐level chronic opioid use trajectories after thoracic surgery, using latent class structures. Demographics, preoperative psychological diagnoses, medication usage and chronic pain variables were utilized to identify population‐level clusters. The cluster identified as highest risk had preoperative chronic opioid use, psychological diagnoses, other medication prescriptions and chronic pain.
Details
- Title: Subtitle
- Opioid use trajectories after thoracic surgery among veterans in the United States
- Creators
- Michael O Bishop - University of Iowa College of Public HealthEmine O Bayman - University of Iowa Carver College of MedicineKatherine Hadlandsmyth - Iowa VA Healthcare SystemBrian C Lund - Iowa VA Healthcare SystemSinyoung Kang - University of Iowa Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- European journal of pain, Vol.24(8), pp.1569-1584
- DOI
- 10.1002/ejp.1610
- PMID
- 32506529
- ISSN
- 1090-3801
- eISSN
- 1532-2149
- Number of pages
- 16
- Grant note
- Veterans Health Administration (VHA) Health Services Research and Development Service University of Iowa
- Language
- English
- Date published
- 09/2020
- Academic Unit
- Psychiatry; Epidemiology; Biostatistics; Anesthesia
- Record Identifier
- 9984214959802771
Metrics
11 Record Views