MP26-12 CHANGING NATIONAL TRENDS IN OPIOID PRESCRIPTIONS FOR PAIN MANAGEMENT IN ACUTE KIDNEY STONE DISEASE

Abstract

You have accessJournal of UrologyCME1 May 2022MP26-12 CHANGING NATIONAL TRENDS IN OPIOID PRESCRIPTIONS FOR PAIN MANAGEMENT IN ACUTE KIDNEY STONE DISEASE Chinmayee Katragadda, Alexis Steinmetz, Alexander Cranwell, and Rajat Jain Chinmayee KatragaddaChinmayee Katragadda More articles by this author , Alexis SteinmetzAlexis Steinmetz More articles by this author , Alexander CranwellAlexander Cranwell More articles by this author , and Rajat JainRajat Jain More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002569.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Deaths from opioid-related overdose contributed to the decline in life expectancy seen in the US from 2014-2018 and surpassed deaths from automobile accidents. Urologic surgery and disease, including benign conditions such as kidney stone disease (KSD), are a significant source of opioid prescriptions. We investigated prescription patterns for opioids and non-opioids for KSD in the Emergency Department (ED) setting. These data provide important information as urologists seek opioid sparing approaches and effective alternative therapies for the KSD population. METHODS: The US National Hospital Ambulatory Medical Care Survey (NHMACS) was queried for ED visits for KSD from 2012 to 2017. Adult patients with KSD-related diagnoses that visited the ED were identified using International Classification of Diseases codes. Prescription rates of opioids and non-opioids were analyzed with respect to age, sex, region, race/ethnicity, and payer type. Survey weighted chi-square and logistic regression, and adjusted odds ratios were used to analyze associations. RESULTS: Six million KSD-related ED visits were identified. The percentage of patients receiving opioid prescriptions decreased from 33% to 16% from 2012-2017 (p-trend <0.001) while non-opioid prescriptions rose from 67% to 84% in that same time period (p-trend <0.02). Compared to 2012, the odds of receiving an opioid prescription decreased significantly in 2016 and 2017 (OR 0.27, p=0.01 and OR 0.12, p<0.0001, respectively). There was a concurrent increase in the odds of receiving a non-opioid prescription in 2016 and 2017 (OR 2.02, p=0.03 and OR 2.63, p=0.01 respectively). Payer type, episode of care and gender were not associated with type of prescription. CONCLUSIONS: The dramatic decrease in opioid prescriptions for kidney stone disease has been accompanied by a concomitant rise in non-opioid prescriptions. This represents a fundamental shift in the management of pain in acute kidney stone disease which is reflective of the nationwide public health effort to curb the opioid epidemic. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e443 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chinmayee Katragadda More articles by this author Alexis Steinmetz More articles by this author Alexander Cranwell More articles by this author Rajat Jain More articles by this author Expand All Advertisement PDF DownloadLoading ...