New persistent opioid use developed in a significant percentage of patients prescribed opioids after ureteroscopy (URS) for the treatment of upper tract stones, according to a study published in Urology.

Deidentified claims data were obtained from the Clinformatics® Data Mart Database, with a focus on adult outpatients who underwent URS for upper tract stone treatment. Only patients who had filled an opioid prescription given for URS were enrolled (n=27,740). Persistent opioid use was defined as the continual use of opioids 3 to 6 months after URS in previously opioid-naive patients.

Of the 51.2% of participants who were opioid naive at the time of URS, new persistent opioid use (ie, daily doses of 4.2 oral morphine equivalents 6 months after URS) developed in 16%.

Patients who were classified into the highest vs lowest tercile of prescribed opioids at URS had a 69% increased odds of new persistent opioid use (odds ratio, 1.69; 95% CI, 1.41-2.03). Individuals with vs without new persistent opioid use after URS were found to be more likely to have filled opioid prescriptions 30 days before the procedure (79.5% vs 75.4%, respectively; P =.006). Factors associated with new persistent opioid use included being a woman (P <.037), being white (P <.003), being less educated (P <.001), having an anxiety or mood disorder (P <.001 for both), and having a pain disorder (P <.001).

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Study limitations include the lack of exact data on the quantity of opioid pills taken by each beneficiary and lack of data on opioid prescription fills that were paid without insurance.

“Given the growing opioid epidemic in the United States and large volume of ureteroscopy procedures performed each year, urologists should re-evaluate their post-URS opioid prescribing patterns,” noted the study authors.

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Reference

Tam CA, Dauw CA, Ghani KR, et al. New persistent opioid use after outpatient ureteroscopy for upper tract stone treatment [published online September 16, 2019]. Urology. doi:10.1016/j.urology.2019.08.042