Differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the United States
Abstract. Introduction:. Low back pain (LBP) is among the leading indications for the prescription of opioid analgesics in clinical practice. There is increasing evidence suggesting that these agents may have diminished efficacy in the treatment of LBP. Objectives:. We evaluated the relationship bet...
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doaj-6c3bc9947f1c44f1bda2e627769056c82020-11-24T22:01:41ZengWolters KluwerPAIN Reports2471-25312017-08-0124e60610.1097/PR9.0000000000000606201708000-00007Differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the United StatesJoyce A. Smith0Robert L. Fuino1Irena Pesis-Katz2Xueya Cai3Bethel Powers4Maria Frazer5John D. Markman6aUniversity of Rochester School of Nursing, Rochester, NY, USAbDepartment of Neurosurgery, Translational Pain Research, University of Rochester School of Medicine and Dentistry, Rochester, NY, USAaUniversity of Rochester School of Nursing, Rochester, NY, USAcDepartment of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USAaUniversity of Rochester School of Nursing, Rochester, NY, USAbDepartment of Neurosurgery, Translational Pain Research, University of Rochester School of Medicine and Dentistry, Rochester, NY, USAbDepartment of Neurosurgery, Translational Pain Research, University of Rochester School of Medicine and Dentistry, Rochester, NY, USAAbstract. Introduction:. Low back pain (LBP) is among the leading indications for the prescription of opioid analgesics in clinical practice. There is increasing evidence suggesting that these agents may have diminished efficacy in the treatment of LBP. Objectives:. We evaluated the relationship between depression, the probability of receiving an opioid prescription, and the amount of morphine equivalent amounts prescribed per year among patients with LBP using nationwide data. Methods:. A cross-sectional analysis was performed on existing data from the Medical Expenditure Panel Survey data set from the period 2004 to 2009. Demographic, medical condition, Patient Health Questionnaire-2 responses, and prescription drug information were obtained on 56,811,864 weighted person-years of data from individuals aged 18 to 65 with an ICD-9 code specific to LBP. Results:. Increases in PHQ-2 score, as well a positive screen for depression, were associated with an increased probability of being prescribed opioid therapy and more morphine equivalents per year. Conclusion:. Analysis of a nationwide sample of patients with LBP shows an association between depression and higher rates of opioid prescribing after controlling for several known cofounders. Clinicians prescribing opioids in LBP populations that rely on clinical trial results that exclude depressed patients may misjudge the risks and benefits of this class of therapy.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000606 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Joyce A. Smith Robert L. Fuino Irena Pesis-Katz Xueya Cai Bethel Powers Maria Frazer John D. Markman |
spellingShingle |
Joyce A. Smith Robert L. Fuino Irena Pesis-Katz Xueya Cai Bethel Powers Maria Frazer John D. Markman Differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the United States PAIN Reports |
author_facet |
Joyce A. Smith Robert L. Fuino Irena Pesis-Katz Xueya Cai Bethel Powers Maria Frazer John D. Markman |
author_sort |
Joyce A. Smith |
title |
Differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the United States |
title_short |
Differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the United States |
title_full |
Differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the United States |
title_fullStr |
Differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the United States |
title_full_unstemmed |
Differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the United States |
title_sort |
differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the united states |
publisher |
Wolters Kluwer |
series |
PAIN Reports |
issn |
2471-2531 |
publishDate |
2017-08-01 |
description |
Abstract. Introduction:. Low back pain (LBP) is among the leading indications for the prescription of opioid analgesics in clinical practice. There is increasing evidence suggesting that these agents may have diminished efficacy in the treatment of LBP.
Objectives:. We evaluated the relationship between depression, the probability of receiving an opioid prescription, and the amount of morphine equivalent amounts prescribed per year among patients with LBP using nationwide data.
Methods:. A cross-sectional analysis was performed on existing data from the Medical Expenditure Panel Survey data set from the period 2004 to 2009. Demographic, medical condition, Patient Health Questionnaire-2 responses, and prescription drug information were obtained on 56,811,864 weighted person-years of data from individuals aged 18 to 65 with an ICD-9 code specific to LBP.
Results:. Increases in PHQ-2 score, as well a positive screen for depression, were associated with an increased probability of being prescribed opioid therapy and more morphine equivalents per year.
Conclusion:. Analysis of a nationwide sample of patients with LBP shows an association between depression and higher rates of opioid prescribing after controlling for several known cofounders. Clinicians prescribing opioids in LBP populations that rely on clinical trial results that exclude depressed patients may misjudge the risks and benefits of this class of therapy. |
url |
http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000606 |
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