@article{ref1,
title="Development of a potential opioid misuse measure from administrative dispensing data and contrasting opioid misuse among individuals on long-term tramadol, long-term short-acting hydrocodone or long-term short-acting oxycodone therapy in Arkansas",
journal="Current medical research and opinion",
year="2022",
author="Acharya, Mahip and Hayes, Corey J. and Li, Chenghui and Painter, Jacob T. and Dayer, Lindsey and Martin, Bradley C.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: This study sought to: 1) construct and validate a composite potential opioid misuse score and, 2) compare potential opioid misuse among individuals prescribed long-term therapy on tramadol, short-acting hydrocodone or short-acting oxycodone. <br><br>METHODS: A retrospective cohort study was conducted using Arkansas All-Payer Claims Database (APCD; 2013-2018) linked to Arkansas Prescription Drug Monitoring Program (PDMP; 2014-2017) and state death certificate data (2013-2018). The study subjects were ambulatory, cancer free adults with incident long-term therapy on tramadol, short-acting hydrocodone or short-acting oxycodone. The number of opioid prescribers/pharmacies, cash payment for opioid prescriptions, overlapping prescribers/pharmacies and a composite misuse score (derived from opioid prescribers/pharmacies and cash payment) were assessed in two 180-day windows as potential measures of misuse. The composite score was developed based on associations observed with opioid overdose and opioid-related injuries. <br><br>RESULTS: A total of 17,816 (tramadol), 23,660 (hydrocodone) and 4,799 (oxycodone) were included. The composite score had modest discrimination for overdose (c-index =0.65). In the 1(st) 180-day period, the average composite misuse scores were 1.28 (tramadol), 1.93 (hydrocodone) and 2.18 (oxycodone). Compared to long-term hydrocodone, long-term tramadol had lower misuse [IRR (95% CI): 0.75 (0.73-0.76)], and long-term oxycodone had higher misuse [1.09 (1.07-1.11)] in adjusted analyses. Qualitatively similar associations were observed for nearly all individual component measures of misuse. <br><br>CONCLUSION: A composite measure of potential opioid misuse had modest levels of discrimination in detecting overdose. In comparison to long-term hydrocodone therapy, long-term oxycodone had higher and tramadol had lower risk of potential opioid misuse.<p /> <p>Language: en</p>",
language="en",
issn="0300-7995",
doi="10.1080/03007995.2022.2112874",
url="http://dx.doi.org/10.1080/03007995.2022.2112874"
}