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Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis.

Publication ,  Journal Article
Check, DK; Baggett, CD; Kim, K; Merlin, JS; Oeffinger, KC; Winn, AN; Roberts, MC; Robinson, T; Dinan, MA
Published in: Support Care Cancer
December 2022

PURPOSE: Cancer is a major reason for concurrent prescription of opioids with other sedating medications-particularly benzodiazepines and gabapentinoids-yet population-based assessments of the extent and predictors of concurrent prescribing among clinically and demographically diverse patients with cancer are lacking. METHODS: We conducted a retrospective cohort study of patients with non-metastatic cancer using North Carolina cancer registry data linked with Medicare and private insurance claims (2013-2016). We used modified Poisson regression to assess associations of patient characteristic with adjusted relative risk (aRR) of new concurrent prescribing of opioids with benzodiazepines or gabapentinoids after diagnosis. RESULTS: Overall, 15% of patients were concurrently prescribed opioids with benzodiazepines or gabapentinoids. Characteristics independently associated with an increased risk of concurrent prescribing included cancer type (e.g., aRR cervical vs. colorectal cancer: 1.55, 95% CI: 1.12-2.14); prior use of opioids (aRR: 2.43, 95% CI:2.21-2.67), benzodiazepines (aRR: 4.08, 95% CI: 3.72-4.48), or gabapentinoids (3.82, 95% CI: 3.31-4.39), and premorbid mental health conditions, including substance use disorder (aRR: 1.27, 95% CI: 1.05-1.54). Black and Hispanic patients were less likely to experience concurrent prescribing (aRR, Black vs. White: 0.35, 95% CI: 0.15-0.83; aRR, Hispanic vs. White: 0.75, 95% CI: 0.66-0.85). CONCLUSION: Approximately 1 in 7 patients with cancer was concurrently prescribed opioids with other sedating medications. Associations between patient characteristics and risk of concurrent prescribing highlight predictors of concurrent prescribing and suggest a rationale for systematic assessment of substance use history at diagnosis. Future research could explore inequitable pain and symptom management and investigate risk of adverse medication-related events.

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Published In

Support Care Cancer

DOI

EISSN

1433-7339

Publication Date

December 2022

Volume

30

Issue

12

Start / End Page

9781 / 9791

Location

Germany

Related Subject Headings

  • United States
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Neoplasms
  • Medicare
  • Humans
  • Benzodiazepines
  • Analgesics, Opioid
  • Aged
  • 52 Psychology
 

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Check, D. K., Baggett, C. D., Kim, K., Merlin, J. S., Oeffinger, K. C., Winn, A. N., … Dinan, M. A. (2022). Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis. Support Care Cancer, 30(12), 9781–9791. https://doi.org/10.1007/s00520-022-07439-y
Check, Devon K., Christopher D. Baggett, KyungSu Kim, Jessica S. Merlin, Kevin C. Oeffinger, Aaron N. Winn, Megan C. Roberts, Timothy Robinson, and Michaela A. Dinan. “Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis.Support Care Cancer 30, no. 12 (December 2022): 9781–91. https://doi.org/10.1007/s00520-022-07439-y.
Check DK, Baggett CD, Kim K, Merlin JS, Oeffinger KC, Winn AN, et al. Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis. Support Care Cancer. 2022 Dec;30(12):9781–91.
Check, Devon K., et al. “Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis.Support Care Cancer, vol. 30, no. 12, Dec. 2022, pp. 9781–91. Pubmed, doi:10.1007/s00520-022-07439-y.
Check DK, Baggett CD, Kim K, Merlin JS, Oeffinger KC, Winn AN, Roberts MC, Robinson T, Dinan MA. Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis. Support Care Cancer. 2022 Dec;30(12):9781–9791.
Journal cover image

Published In

Support Care Cancer

DOI

EISSN

1433-7339

Publication Date

December 2022

Volume

30

Issue

12

Start / End Page

9781 / 9791

Location

Germany

Related Subject Headings

  • United States
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Neoplasms
  • Medicare
  • Humans
  • Benzodiazepines
  • Analgesics, Opioid
  • Aged
  • 52 Psychology