Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study

Gabrielle Campbell; Firouzeh Noghrehchi; Suzanne Nielsen; Phillip Clare; Raimondo Bruno; Nicholas Lintzeris; Milton Cohen; Fiona Blyth; Wayne D Hall; Briony Larance; Phillip Hungerford; Timothy Dobbins; Michael Farrell; Louisa Degenhardt

doi:10.1016/j.eclinm.2020.100592

Back

Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study

Journal article

Open access

Peer reviewed

Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study

Gabrielle Campbell, Firouzeh Noghrehchi, Suzanne Nielsen, Phillip Clare, Raimondo Bruno, Nicholas Lintzeris, Milton Cohen, Fiona Blyth, Wayne D Hall, Briony Larance, …

EClinicalMedicine, Vol.28, 100592

2020

DOI: https://doi.org/10.1016/j.eclinm.2020.100592

Files and links (2)

pdf

Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain_ Findings from a 5-year prospective cohort study1.09 MBDownload View

Published Version Open Access CC BY-NC-ND V4.0

url

https://doi.org/10.1016/j.eclinm.2020.100592View

Published Version

Abstract

chronic non-cancer pain

pharmaceutical opioid

dependence

extra medical use

cohort

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 - Legacy
Firouzeh Noghrehchi (Author) - The University of Sydney
Suzanne Nielsen (Author) - UNSW Australia
Phillip Clare (Author) - UNSW Australia
Raimondo Bruno (Author) - University of Tasmania
Nicholas Lintzeris (Author) - The University of Sydney
Milton Cohen (Author) - St Vincent's Hospital Sydney
Fiona Blyth (Author) - The University of Sydney
Wayne D Hall (Author) - The University of Queensland
Briony Larance (Author) - UNSW Australia
Phillip Hungerford (Author) - UNSW Australia
Timothy Dobbins (Author) - UNSW Australia
Michael Farrell (Author) - UNSW Australia
Louisa 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/)
Data Availability: Request for access to the data should be made to the corresponding author
Grants: The extent and impact of pharmaceutical opioids for chronic non-cancer pain, 1119992, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Pharmaceutical opioid prescription for chronic pain in Australia: Trajectories of prescribing, risk of adverse events, and predictors of harm, 1022522, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Pharmaceutical opioids for chronic non-cancer pain: Evaluating health outcomes and economic impact over five years, 1100822, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Implementation research to treat and prevent opioid related harms, 1163961, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Increasing knowledge about substance use, mental health and harms, and interventions to prevent and reduce harm, 1135991, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Grant note: LD receives support from through a National Institute of Health (NIH) National Institute on Drug Abuse (NIDA) grant (R01DA1104470). The National Drug and Alcohol Research Centre, UNSW Sydney, is supported by funding from the Australian Government Department of Health under the Drug and Alcohol Program.
Organisation Unit: School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99484008102621
Output Type: Journal article

Metrics

1 File views/ downloads

36 Record Views

31 Times Cited - Web of Science

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Medicine, General & Internal

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

Source: InCites