TY  - JOUR
PY  - 2022//
TI  - 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
JO  - Current medical research and opinion
A1  - Acharya, Mahip
A1  - Hayes, Corey J.
A1  - Li, Chenghui
A1  - Painter, Jacob T.
A1  - Dayer, Lindsey
A1  - Martin, Bradley C.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 0300-7995
UR  - http://dx.doi.org/10.1080/03007995.2022.2112874
ID  - ref1
ER  -