Journal article
Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study
EClinicalMedicine, Vol.28, 100592
2020
Abstract
Background:
The literature suggests patient characteristics and higher opioid doses and long-term duration are associated with problematic opioid behaviours but no one study has examined the role of all these factors simultaneously in a long-term prospective cohort study.
Methods:
Five-year, community-based, prospective cohort of people prescribed opioids for chronic non-cancer pain (CNCP). Logistic mixed effect models with multiple imputation were used to address missing data. Oral morphine equivalent (OME) mg per day was categorised as: 0 mg OME/day, 1–49 mg OME/day (reference), 50–89 mg OME/day, 90–199 mg OME/day and 200mg+ OME/day. Patient risk factors included: age, gender, substance use, mental health history and pain-related factors. Main outcomes included: Prescribed Opioids Difficulties Scale (PODS), Opioid-Related Behaviours In Treatment (ORBIT) scale, and ICD-10 opioid dependence. Multiple confounders for problematic opioid behaviours were assessed.
Findings:
Of 1,514 participants 44.4% were male (95%CI 41.9–46.9) and their mean age was 58 years (IQR 48–67). Participants had a mean duration of pain of 10 years (IQR 4.5–20.0) and had been taking strong opioids for a median of four years (IQR 1.0–10.0). At baseline, median OME/day was 73 (IQR 35–148). At 5-years, 85% were still taking strong opioids. PODS moderate-high scores reduced from 59.9% (95%CI 58.8–61.0) at baseline to 51.5% (95%CI 50.0–53.0) at 5-years. Around 9% met criteria for ICD-10 opioid dependence at each wave. In adjusted mixed effect models, the risk factors most consistently associated with problematic opioid use were: younger age, substance dependence, mental health histories and higher opioid doses.
Interpretation:
Both patient risk factors and opioid dose are associated with problematic opioid use behaviours.
Details
- Title
- Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study
- Authors
- Gabrielle Campbell (Author) - University of the Sunshine Coast, Queensland, School of Health and Sport Sciences - LegacyFirouzeh Noghrehchi (Author) - The University of SydneySuzanne Nielsen (Author) - UNSW AustraliaPhillip Clare (Author) - UNSW AustraliaRaimondo Bruno (Author) - University of TasmaniaNicholas Lintzeris (Author) - The University of SydneyMilton Cohen (Author) - St Vincent's Hospital SydneyFiona Blyth (Author) - The University of SydneyWayne D Hall (Author) - The University of QueenslandBriony Larance (Author) - UNSW AustraliaPhillip Hungerford (Author) - UNSW AustraliaTimothy Dobbins (Author) - UNSW AustraliaMichael Farrell (Author) - UNSW AustraliaLouisa Degenhardt (Author) - UNSW Australia
- Publication details
- EClinicalMedicine, Vol.28, 100592
- Publisher
- Elsevier Ltd.
- Date published
- 2020
- DOI
- 10.1016/j.eclinm.2020.100592
- ISSN
- 2589-5370
- Copyright note
- (c) 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy
- Language
- English
- Record Identifier
- 99484008102621
- Output Type
- Journal article
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