MP43-19 PERSISTENTLY HIGH LEVELS OF OPIOID UTILIZATION AMONG PATIENTS WITH URINARY STONE DISEASE

Abstract

INTRODUCTION AND OBJECTIVE: Urinary stone disease (USD) is painful, and its surgical treatment is oftentimes associated with pain as well. The scope of opioid utilization to mitigate USD associated pain is not well understood. As part of the Urological Diseases in America project, we assessed the prescription of opioid agents among a national sample of USD patients over an 8-year period. METHODS: Two insurance claims databases were analyzed over the 2006-2013 study period: the Centers for Medicare & Medicaid Services Medicare 5% Sample for beneficiaries aged ≥65 years with USD (N≈21,000 annually) and the Optum© de-identified Clinformatics® Data Mart Database (CDM) for privately insured adults aged 18-64 years with USD (N≈61,000 annually). The percentage of patients receiving opioid agent prescriptions was assessed annually over the study period. RESULTS: Approximately three-fourths of USD patients filled a prescription of any kind in the course of their treatment. Opioid agents were the most common pharmaceutical prescribed, followed by alpha blockers and calcium channel blockers (Figure 1). The prevalence of opioid agonist prescription fills was higher among privately insured USD patients (range: 65-67%) compared to Medicare USD patients (range: 55-58%). Among both study populations, the high prevalence of opioid agent prescription fills persisted throughout the 8-year study period. CONCLUSIONS: Opioid agents are commonly prescribed to USD patients, and this practice persisted over the study period. An understanding of the scope of the opioid prescribing among stone patients is the first step in a pathway towards reducing reliance on this medication. Given how commonly opioids are utilized among USD patients, and given the recognized health risks associated with these agents, developing clinical pathways that decrease reliance on opioid agents is particularly important.Source of Funding: Funded by the NIH via a contract to Social & Scientific Systems.