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New Chronic Opioid Use in Medicaid Patients Following Cholecystectomy

29 Pages Posted: 24 Mar 2022 Publication Status: Published

See all articles by Mark Lockett

Mark Lockett

Medical University of South Carolina

Ralph C. Ward

Medical University of South Carolina

Jenna L. McCauley

Medical University of South Carolina

David J. Taber

Medical University of South Carolina

Mulugeta Gebregziabher

Government of the United States of America - Charleston Health Equity and Rural Outreach Innovation Center (HEROIC); Medical University of South Carolina - Department of Public Health Sciences

Robert Cina

Medical University of South Carolina

William Basco

Medical University of South Carolina

Patrick D. Mauldin

Medical University of South Carolina - College of Medicine

Sarah J. Ball

Medical University of South Carolina

Abstract

Background: Commercial insurance data shows chronic opioid use in opioid naïve patients occurs in 1.5% to 8% of patients undergoing surgical procedures but little is known about patients with Medicaid.

Methods: Opioid prescription data and medical coding data from 4,788 Medicaid patients who underwent cholecystectomy was analyzed to determine opioid use patterns.

Results: 54.4% of patients received opioids prior to surgery, and 38.8% continued to fill opioid prescriptions chronically.  27.1% of opioid naive patients continued to get opioids chronically. Patients who received ≥ 50 MME/day had nearly 8 times the odds of chronic opioid use.  Each additional opioid prescription filled within 30 days was associated with increased odds of chronic use (OR: 1.71).

Conclusions: Opioid prescriptions are common prior to cholecystectomy in Medicaid patients and 38.8% of patients continue to receive opioid prescriptions well after surgical recovery. Even 27.1% of opioid naïve patients continued to receive opioid prescriptions chronically.

Funding Information: Data used in this project were received through a contract (A201912450A) with the SC Department of Health and Human Services (SCDHHS) for Drug Utilization Review services and supported in part by the NIH National Institute on Drug Abuse (NIDA) grant DA0036566 NIH and the National Center for Advancing Translational Sciences (NCATS) through Grant Number UL1 TR001450.

Declaration of Interests: S Ball and R Ward receive salary support from the SCDHHS grant. M Lockett receives salary support from the South Carolina Surgical Quality Collaborative. All additional authors have no disclosures.

Ethics Approval Statement: This study was approved by the Medical University of South Carolina Institutional Review Board. This work is considered quality improvement work and was exempt from IRB approval.

Note:

Keywords: Opioids, Surgery, Cholecystectomy, Outcomes, pain

Suggested Citation

Lockett, Mark and Ward, Ralph C. and McCauley, Jenna L. and Taber, David J. and Gebregziabher, Mulugeta and Cina, Robert and Basco, William and Mauldin, Patrick D. and Ball, Sarah J., New Chronic Opioid Use in Medicaid Patients Following Cholecystectomy. Available at SSRN: https://ssrn.com/abstract=4038310 or http://dx.doi.org/10.2139/ssrn.4038310

Mark Lockett (Contact Author)

Medical University of South Carolina ( email )

171 Ashley Avenue
Charleston, SC 29425
United States

Ralph C. Ward

Medical University of South Carolina ( email )

171 Ashley Avenue
Charleston, SC 29425
United States

Jenna L. McCauley

Medical University of South Carolina ( email )

David J. Taber

Medical University of South Carolina ( email )

Mulugeta Gebregziabher

Government of the United States of America - Charleston Health Equity and Rural Outreach Innovation Center (HEROIC) ( email )

Charleston, SC
United States

Medical University of South Carolina - Department of Public Health Sciences ( email )

Charleston, SC
United States

Robert Cina

Medical University of South Carolina ( email )

William Basco

Medical University of South Carolina ( email )

Patrick D. Mauldin

Medical University of South Carolina - College of Medicine

171 Ashley Avenue
Charleston, SC 29425
United States

Sarah J. Ball

Medical University of South Carolina ( email )

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