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Prevalence and Patterns of Opioid Use Before and After Liver Transplantation.

Publication ,  Journal Article
Cron, DC; Tincopa, MA; Lee, JS; Waljee, AK; Hammoud, A; Brummett, CM; Waljee, JF; Englesbe, MJ; Sonnenday, CJ
Published in: Transplantation
January 1, 2021

BACKGROUND: Opioid use in liver transplantation is poorly understood and has potential associated morbidity. METHODS: Using a national data set of employer-based insurance claims, we identified 1257 adults who underwent liver transplantation between December 2009 and February 2015. We categorized patients based on their duration of opioid fills over the year before and after transplant admission as opioid-naive/no fills, chronic opioid use (≥120 d supply), and intermittent use (all other use). We calculated risk-adjusted prevalence of peritransplant opioid fills, assessed changes in opioid use after transplant, and identified correlates of persistent or increased opioid use posttransplant. RESULTS: Overall, 45% of patients filled ≥1 opioid prescription in the year before transplant (35% intermittent use, 10% chronic). Posttransplant, 61% of patients filled an opioid prescription 0-2 months after discharge, and 21% filled an opioid between 10-12 months after discharge. Among previously opioid-naive patients, 4% developed chronic use posttransplant. Among patients with pretransplant opioid use, 84% remained intermittent or increased to chronic use, and 73% of chronic users remained chronic users after transplant. Pretransplant opioid use (risk factor) and hepatobiliary malignancy (protective) were the only factors independently associated with risk of persistent or increased posttransplant opioid use. CONCLUSIONS: Prescription opioid use is common before and after liver transplant, with intermittent and chronic use largely persisting, and a small development of new chronic use posttransplant. To minimize the morbidity of long-term opioid use, it is critical to improve pain management and optimize opioid use before and after liver transplant.

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Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

January 1, 2021

Volume

105

Issue

1

Start / End Page

100 / 107

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Surgery
  • Risk Factors
  • Risk Assessment
  • Practice Patterns, Physicians'
  • Middle Aged
  • Male
  • Liver Transplantation
 

Citation

APA
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ICMJE
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Cron, D. C., Tincopa, M. A., Lee, J. S., Waljee, A. K., Hammoud, A., Brummett, C. M., … Sonnenday, C. J. (2021). Prevalence and Patterns of Opioid Use Before and After Liver Transplantation. Transplantation, 105(1), 100–107. https://doi.org/10.1097/TP.0000000000003155
Cron, David C., Monica A. Tincopa, Jay S. Lee, Akbar K. Waljee, Ali Hammoud, Chad M. Brummett, Jennifer F. Waljee, Michael J. Englesbe, and Christopher J. Sonnenday. “Prevalence and Patterns of Opioid Use Before and After Liver Transplantation.Transplantation 105, no. 1 (January 1, 2021): 100–107. https://doi.org/10.1097/TP.0000000000003155.
Cron DC, Tincopa MA, Lee JS, Waljee AK, Hammoud A, Brummett CM, et al. Prevalence and Patterns of Opioid Use Before and After Liver Transplantation. Transplantation. 2021 Jan 1;105(1):100–7.
Cron, David C., et al. “Prevalence and Patterns of Opioid Use Before and After Liver Transplantation.Transplantation, vol. 105, no. 1, Jan. 2021, pp. 100–07. Pubmed, doi:10.1097/TP.0000000000003155.
Cron DC, Tincopa MA, Lee JS, Waljee AK, Hammoud A, Brummett CM, Waljee JF, Englesbe MJ, Sonnenday CJ. Prevalence and Patterns of Opioid Use Before and After Liver Transplantation. Transplantation. 2021 Jan 1;105(1):100–107.

Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

January 1, 2021

Volume

105

Issue

1

Start / End Page

100 / 107

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Surgery
  • Risk Factors
  • Risk Assessment
  • Practice Patterns, Physicians'
  • Middle Aged
  • Male
  • Liver Transplantation