1. Regional and temporal variation in receipt of long-term opioid therapy among older breast, colorectal, lung, and prostate cancer survivors in the United States.
- Author
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Gibson DC, Raji MA, Baillargeon JG, and Kuo YF
- Subjects
- Aged, Aged, 80 and over, Cancer Pain drug therapy, Censuses, Confidence Intervals, Female, Humans, Male, Medicare statistics & numerical data, Multivariate Analysis, Odds Ratio, Retrospective Studies, SEER Program statistics & numerical data, Time Factors, United States epidemiology, Analgesics, Opioid therapeutic use, Breast Neoplasms epidemiology, Breast Neoplasms mortality, Cancer Survivors statistics & numerical data, Colorectal Neoplasms epidemiology, Colorectal Neoplasms mortality, Lung Neoplasms epidemiology, Lung Neoplasms mortality, Prostatic Neoplasms epidemiology, Prostatic Neoplasms mortality
- Abstract
Background: Older cancer survivors have high rates of long-term opioid therapy (≥90 days/year). However, the geographical and temporal variation in long-term opioid therapy rates for older cancer survivors is not known., Methods: A retrospective cohort study was conducted using SEER-Medicare data. Persons aged ≥66 years, diagnosed with breast, colorectal, lung, or prostate cancer from 1991 to 2011, and alive ≥5 years after diagnosis were included. Persons were followed from 1/1/2008 until 12/31/2016. Persons were assigned to a census region in their state of residence each year. Individuals who were covered by an opioid prescription for at least 90 days in a calendar year were classified as having received long-term opioid therapy. Multivariable analysis was conducted using generalized estimating equations., Results: Temporal trends significantly varied by region (p < 0.0001) and opioid-naïve status (p < 0.0001). Compared to 2013, opioid-naïve cancer survivors in the south and non-naïve survivors in the south and west experienced significant declines in long-term opioid therapy in 2015 and 2016. Significant declines were observed in 2016 for opioid-naïve and non-naïve cancer survivors residing in the northeast and among opioid-naïve cancer survivors living in the Midwest., Conclusion: The annual trends in the receipt of long-term opioid therapy significantly varied by region among older cancer survivors. Variation in a clinical practice suggests the need for more research and interventions to improve efficiency, process, cost, and quality of care., (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Published
- 2021
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