MP80-03 OPIOID USE IN VETERANS WITH PROSTATE CANCER FOLLOWING SURGERY TREATMENT

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP80-03 OPIOID USE IN VETERANS WITH PROSTATE CANCER FOLLOWING SURGERY TREATMENT Sumedha Chhatre, S Bruce Malkowicz, Thomas Guzzo, Marilyn Schapira, and Ravishankar Jayadevappa Sumedha ChhatreSumedha Chhatre More articles by this author , S Bruce MalkowiczS Bruce Malkowicz More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Marilyn SchapiraMarilyn Schapira More articles by this author , and Ravishankar JayadevappaRavishankar Jayadevappa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003357.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Opioid use for pain management in cancer patients is a challenge. Study objective was to determine the incidence of persistent opioid use in Veterans with early stage prostate cancer and treated with surgery. METHODS: Retrospective cohort study of Veterans diagnosed with prostate cancer between 2015 and 2016. Opioid exposure attributable to treatment was defined as the cumulative oral or topical Morphine Milligram Equivalents (MMEs) prescribed from 31 days prior to 14 days post index surgery. Outcome was any opioid use in the 13-month follow-up period. Eligibility criteria was Veterans receiving care at a VA Medical Center, aged ≥21 years, early stage prostate cancer, surgery treatment at VA Medical Center, and opioid naïve in the period 12 months to 31 days prior to index surgery. Logistic regression was used to model association between any opioid use in the follow-up period as a function of any baseline opioid use, baseline opioid use (MMEs), age, race, ethnicity, socio-economic status, dual enrollment-Medicare Part D, comorbidity, mental health conditions, chronic pain, non-opioid pain medications, cancer treatment (adjuvant chemotherapy, radiation, immunotherapy), and district. RESULTS: 2,594 Veterans with prostate cancer met our criteria. Proportion of Veterans with opioid use during the 13-moth follow-up period is shown in Table 1. The largest opioid use was observed in the first follow-up month (31.5%), and 42.5% had at least one month of opioid use in the follow-up period. Baseline opioid use (OR=5.3, 95% CI=4.1, 6.9), diagnosis year 2015 (OR=1.6, 95% CI=1.3, 1.9), Elixhauser comorbidity score of 1-3 (OR=1.9, 95% CI=1.4, 2.7), chronic pain (OR=1.4, 95% CI=1.2, 1.7), anxiety, depression or PTSD (OR=1.4, 95% CI=1.1, 1.8), and Pacific district were associated with higher risk of opioid use in the follow-up period. Dual Medicare enrollment (OR=0.73, 95% CI=0.57, 0.94), and cancer stage I (OR=0.44, 95% CI=0.30, 0.63) were associated with lower risk of opioid use in follow-up period. CONCLUSIONS: Opioid use immediately after surgery was associated with continued opioid use in the follow-up period. This has implications for optimizing pain management for Veterans with prostate cancer. Source of Funding: VA HSR&D PPO 20-121 and DoD W81XWH-19-1-0461 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1152 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sumedha Chhatre More articles by this author S Bruce Malkowicz More articles by this author Thomas Guzzo More articles by this author Marilyn Schapira More articles by this author Ravishankar Jayadevappa More articles by this author Expand All Advertisement PDF downloadLoading ...