Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient Cohort
Introduction: Urolithiasis causes severe acute pain and is commonly treated with opioid analgesics in the emergency department (ED). We examined opioid analgesic use after episodes of acute pain. Methods: Using data from a longitudinal trial of ED patients with urolithiasis, we constructed multivari...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2022-10-01
|
| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/81c5k9xj |
| _version_ | 1811306515065208832 |
|---|---|
| author | Anna E. Wentz Ralph C. Wang Brandon D.L. Marshall Theresa I. Shireman Tao Liu Roland C. Merchant |
| author_facet | Anna E. Wentz Ralph C. Wang Brandon D.L. Marshall Theresa I. Shireman Tao Liu Roland C. Merchant |
| author_sort | Anna E. Wentz |
| collection | DOAJ |
| description | Introduction: Urolithiasis causes severe acute pain and is commonly treated with opioid analgesics in the emergency department (ED). We examined opioid analgesic use after episodes of acute pain. Methods: Using data from a longitudinal trial of ED patients with urolithiasis, we constructed multivariable models to estimate the adjusted probability of opioid analgesic use 3, 7, 30, and 90 days after ED discharge. We used multiple imputation to account for missing data and weighting to account for the propensity to be prescribed an opioid analgesic at ED discharge. We used weighted multivariable regression to compare longitudinal opioid analgesic use for those prescribed vs not prescribed an opioid analgesic at discharge, stratified by reported pain at ED discharge. Results: Among 892 adult ED patients with urolithiasis, 79% were prescribed an opioid analgesic at ED discharge. Regardless of reporting pain at ED discharge, those who were prescribed an opioid analgesic were significantly more likely to report using it one, three, and seven days after the visit in weighted multivariable analysis. Among those who were not prescribed an opioid analgesic, an estimated 21% (not reporting pain at ED discharge) and 30% (reporting pain at discharge) reported opioid analgesic use at day three. Among those prescribed an opioid analgesic, 49% (no pain at discharge) and 52% (with pain at discharge) reported using an opioid analgesic at day three. Conclusion: Urolithiasis patients who received an opioid analgesic at ED discharge were more likely to continue using an opioid analgesic than those who did not receive a prescription at the initial visit, despite the time-limited nature of urolithiasis. |
| first_indexed | 2024-04-13T08:46:57Z |
| format | Article |
| id | doaj.art-b920d538bda4491f94ba563084e9e560 |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-04-13T08:46:57Z |
| publishDate | 2022-10-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-b920d538bda4491f94ba563084e9e5602022-12-22T02:53:38ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182022-10-0123610.5811/westjem.2022.8.56679wjem-23-864Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient CohortAnna E. Wentz0Ralph C. Wang1Brandon D.L. Marshall2Theresa I. Shireman3Tao Liu4Roland C. Merchant5Brown University School of Public Health, Department of Epidemiology, Providence, Rhode IslandUniversity of California, San Francisco, Department of Emergency Medicine, San Francisco, CaliforniaBrown University School of Public Health, Department of Epidemiology, Providence, Rhode IslandBrown University School of Public Health, Health Services Policy & Practice, Providence, Rhode IslandBrown University School of Public Health, Data & Statistics Core of Brown Alcohol Research Center on HIV (ARCH), Providence, Rhode IslandHarvard Medical School, Brigham and Women’s Hospital Department of Emergency Medicine, Boston, MassachusettsIntroduction: Urolithiasis causes severe acute pain and is commonly treated with opioid analgesics in the emergency department (ED). We examined opioid analgesic use after episodes of acute pain. Methods: Using data from a longitudinal trial of ED patients with urolithiasis, we constructed multivariable models to estimate the adjusted probability of opioid analgesic use 3, 7, 30, and 90 days after ED discharge. We used multiple imputation to account for missing data and weighting to account for the propensity to be prescribed an opioid analgesic at ED discharge. We used weighted multivariable regression to compare longitudinal opioid analgesic use for those prescribed vs not prescribed an opioid analgesic at discharge, stratified by reported pain at ED discharge. Results: Among 892 adult ED patients with urolithiasis, 79% were prescribed an opioid analgesic at ED discharge. Regardless of reporting pain at ED discharge, those who were prescribed an opioid analgesic were significantly more likely to report using it one, three, and seven days after the visit in weighted multivariable analysis. Among those who were not prescribed an opioid analgesic, an estimated 21% (not reporting pain at ED discharge) and 30% (reporting pain at discharge) reported opioid analgesic use at day three. Among those prescribed an opioid analgesic, 49% (no pain at discharge) and 52% (with pain at discharge) reported using an opioid analgesic at day three. Conclusion: Urolithiasis patients who received an opioid analgesic at ED discharge were more likely to continue using an opioid analgesic than those who did not receive a prescription at the initial visit, despite the time-limited nature of urolithiasis.https://escholarship.org/uc/item/81c5k9xj |
| spellingShingle | Anna E. Wentz Ralph C. Wang Brandon D.L. Marshall Theresa I. Shireman Tao Liu Roland C. Merchant Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient Cohort Western Journal of Emergency Medicine |
| title | Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient Cohort |
| title_full | Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient Cohort |
| title_fullStr | Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient Cohort |
| title_full_unstemmed | Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient Cohort |
| title_short | Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient Cohort |
| title_sort | opioid analgesic use after an acute pain visit evidence from a urolithiasis patient cohort |
| url | https://escholarship.org/uc/item/81c5k9xj |
| work_keys_str_mv | AT annaewentz opioidanalgesicuseafteranacutepainvisitevidencefromaurolithiasispatientcohort AT ralphcwang opioidanalgesicuseafteranacutepainvisitevidencefromaurolithiasispatientcohort AT brandondlmarshall opioidanalgesicuseafteranacutepainvisitevidencefromaurolithiasispatientcohort AT theresaishireman opioidanalgesicuseafteranacutepainvisitevidencefromaurolithiasispatientcohort AT taoliu opioidanalgesicuseafteranacutepainvisitevidencefromaurolithiasispatientcohort AT rolandcmerchant opioidanalgesicuseafteranacutepainvisitevidencefromaurolithiasispatientcohort |