Variations in opioid prescribing in low again ache sufferers with and with out despair: a cross-sectional research of a nationwide pattern from the US.
Ache Rep. 2017 Jul;2(four):e606
Authors: Smith JA, Fuino RL, Pesis-Katz I, Cai X, Powers B, Frazer M, Markman JD
Summary
Introduction: Low again ache (LBP) is among the many main indications for the prescription of opioid analgesics in medical follow. There’s rising proof suggesting that these brokers could have diminished efficacy within the remedy of LBP.
Goals: We evaluated the connection between despair, the chance of receiving an opioid prescription, and the quantity of morphine equal quantities prescribed per 12 months amongst sufferers with LBP utilizing nationwide information.
Strategies: A cross-sectional evaluation was carried out on present information from the Medical Expenditure Panel Survey information set from the interval 2004 to 2009. Demographic, medical situation, Affected person Well being Questionnaire-2 responses, and prescription drug info had been obtained on 56,811,864 weighted person-years of knowledge from people aged 18 to 65 with an ICD-9 code particular to LBP.
Outcomes: Will increase in PHQ-2 rating, as effectively a constructive display for despair, had been related to an elevated chance of being prescribed opioid remedy and extra morphine equivalents per 12 months.
Conclusion: Evaluation of a nationwide pattern of sufferers with LBP exhibits an affiliation between despair and better charges of opioid prescribing after controlling for a number of identified cofounders. Clinicians prescribing opioids in LBP populations that depend on medical trial outcomes that exclude depressed sufferers could misjudge the dangers and advantages of this class of remedy.
PMID: 29392221 [PubMed]