Predicting the risk for aberrant opioid use behavior in patients receiving outpatient supportive care consultation at a comprehensive cancer center

Yennurajalingam, Sriram; Edwards, Tonya; Arthur, Joseph; Lu, Zhanni; Najera, John M; Nguyen, Kristy; Joy, Michael; Kuriakose, Leela; Wu, Jimin; Liu, Diane; Williams, Janet L.; Reddy, Suresh; Bruera, Éduardo

doi:10.1002/cncr.31670

Cited by 47 publications

(73 citation statements)

References 36 publications

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“…It is an important distinction to make in such patients to enable safe prescribing and enhancing quality of life. In the USA, prevalence rates of drug misuse in patients with cancer range from 3% to 19%; however, population-level issues are considerably higher in the USA making it difficult to extrapolate 13–15…”

Section: Introductionmentioning

confidence: 99%

Alcohol and drug use disorders in patients with cancer and caregivers: effects on caregiver burden

Webber

Davies

Leach

et al. 2020

BMJ Support Palliat Care

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BackgroundThe estimated prevalence of alcohol use disorders in patients with advanced cancer is reported as 4%–38%. There are limited data regarding alcohol and drug use disorders in caregivers of patients with cancer and the effects on other issues.AimTo establish the prevalence of alcohol and drug use disorders in a large cohort of patients with advanced cancer and their caregivers.To evaluate the relationship between alcohol and drug use disorders and patient symptoms and caregiver burden.DesignThe patient with cancer and caregiver completed the Alcohol Use Disorders Identification Tool, CAGE questionnaire and Drug Abuse Screening Test. The patient completed the Memorial Symptom Assessment Scale–Short Form, and the caregiver completed the Zarit Burden Questionnaire.Statistical analysis compared cases and non-cases of alcohol and drug use disorders with symptom and burden score.Setting/participantsPatients with cancer, and their caregivers, were recruited from 11 UK sites, 6 hospices and 5 hospitals.ResultsFive hundred and seven patients and their caregivers were recruited. Twenty-seven patients (5%) and 44 caregivers (9%) screened positively for alcohol use disorders on the Alcohol Use Disorders Identification Tool. Thirty patients (6%), and 16 caregivers (3%), screened positively for drug abuse problems on the Drug Abuse Screening Test.There was a significantly higher carer burden score in caregivers screening positively for alcohol and drug abuse problems.ConclusionsThe prevalence of alcohol use disorders in patients with cancer and caregivers was lower than reported in previous studies. Caregiver burden scores were significantly higher in carers screening positively for alcohol and drug use disorders.Trial registration numberTrial registered National Institute for Health Research Clinical Research Network Portfolio (CPMS ID 30723) IRAS ID 198753.

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Section: Introductionmentioning

confidence: 99%

Alcohol and drug use disorders in patients with cancer and caregivers: effects on caregiver burden

Webber

Davies

Leach

et al. 2020

BMJ Support Palliat Care

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“…The relationship between the odds for opioid use, and by extension pain medication use in general, and the level of symptoms of depression, general anxiety and catastrophizing suggests that it might be possible to decrease excessive opioid use by managing depressive symptoms better [48]. Moreover, it has been suggested that there might be a positive relationship between symptoms of depression [55,[141][142][143][144] and/or anxiety [55,141,142,144] and non-adherence to medication recommendations (e.g., pain medication dependence, overuse or taking someone else's prescription). Such non-adherence to medication recommendations is one of the causes of the opioid epidemic, indicating that it might be useful to target these CEF in clinical practice in an attempt to decrease medication misuse, withholding great potential for impacting upon the opioid epidemic.…”

Section: Discussion Of Confirmed Associationsmentioning

confidence: 99%

The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

Huysmans

Leemans

Beckwée

et al. 2020

JCM

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Pain conditions are among the leading causes of global disability, impacting on global healthcare utilization (HCU). Health seeking behavior might be influenced by cognitive and emotional factors (CEF), which can be tackled by specific therapies. The purpose of this study was to systematically review the evidence concerning associations between CEF and HCU in people experiencing pain. Three databases were consulted: PubMed, Web of Science and EconLit. Risk of bias was assessed using the Downs and Black Checklist (modified). A total of 90 publications (total sample n = 59,719) was included after double-blind screening. In people experiencing pain, positive associations between general anxiety symptoms, depressive symptoms and catastrophizing and pain medication use were found. Additionally, there appears to be a relationship between general anxiety and depressive symptoms and opioid use. Symptom-related anxiety and psychological distress were found to be positively related with consulting behavior. Last, a positive association between use of complementary and alternative medicine and level of perceived symptom control was confirmed in people with pain. For other relationships no evidence or inconsistent findings were found, or they were insufficiently studied to draw firm conclusions, indicating that more research on this topic is needed.

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“…These findings underscore the importance of additional measures to reduce the risk of long-term opioid use. The use of validated screening tools in all patients using prescription opioids [34,35], and the targeting of psychosocial issues to combat 'chemical coping' [36,37] are examples of additional measures that may be used in conjunction with opioid-sparing approaches.…”

Section: Discussionmentioning

confidence: 99%

Patterns and predictors of outpatient opioid use after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Owusu-Agyemang

Cata

Kapoor

et al. 2019

International Journal of Hyperthermia

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2019) Patterns and predictors of outpatient opioid use after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, International ABSTRACT Background: Long-term opioid use is a well-known complication after surgery. In this retrospective study of adults who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), we sought to determine the rates and factors associated with outpatient opioid use within the sixth and twelfth postoperative months. Methods: Records of 288 opioid-naïve patients were included. Logistic regression models were used to determine factors prognostic of outpatient opioid use. Results: The median patient age was 54 years, and 63% were female. Rates of outpatient opioid use within the sixth and twelfth postoperative months were 21 and 13%, respectively. In the multivariate analysis, every doubling in the amount of in-hospital postoperative opioid consumption was associated with a 44% increase in odds of opioid use within the sixth postoperative month (OR 1.44, 95% CI 1.11-1.87, p ¼ .006) and a 70% increase within the twelfth postoperative month (OR 1.70, 95% CI 1.70-2.37, p ¼ .001). Other factors associated with opioid use within the sixth postoperative month included physical status (OR 5.26, 95% CI 1.08-25.55, p ¼ .039) and recent additional surgery (OR 23.02, 95% CI 2.03-261.30, p ¼ .011). Age (OR 4.39, 95% CI 1.77-10.89, p ¼ .001) and tumor grade (OR 3.31, 95% CI 1.31-8.41, p ¼ .012) were associated with opioid use within the twelfth postoperative month. Conclusion: In this study, the amount of in-hospital postoperative opioid consumption was an important contributory factor to outpatient opioid use in the sixth and twelfth postoperative months. SYNOPSISIn this study of adults who had undergone CRS-HIPEC, higher postoperative opioid consumption during hospitalization was associated with higher odds of opioid use within the sixth and twelfth postoperative months. ARTICLE HISTORY

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Predicting the risk for aberrant opioid use behavior in patients receiving outpatient supportive care consultation at a comprehensive cancer center

Abstract: The current results indicate a high frequency of an elevated risk of ADB among patients with cancer. Men and patients who have anxiety, financial distress, and a prior history of alcoholism/illicit drug use are at increased risk of ADB.

Cited by 47 publications

References 36 publications

Alcohol and drug use disorders in patients with cancer and caregivers: effects on caregiver burden

Alcohol and drug use disorders in patients with cancer and caregivers: effects on caregiver burden

The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

Patterns and predictors of outpatient opioid use after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

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