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Surgeons often see patients with pain to exclude organic pathology and consider surgical treatment. We examined factors associated with long-term opioid therapy among patients with foot/ankle, anorectal, and temporomandibular joint pain to aid clinical decision making.
Using the IBM MarketScan® Research Database, we conducted a retrospective cohort analysis of patients aged 18-64 with a clinical encounter for foot/ankle, anorectal, or temporomandibular joint pain (January 2007-September 2015). Multivariable logistic regression was used to estimate adjusted odds ratios for factors associated with long-term opioid therapy, including age, sex, geographic region, pain condition, psychiatric diagnoses, and surgical procedures in the previous year.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Anorectal | Patients presenting with anorectal pain. |
| |
| TMJ | Patients presenting with temporomandibular joint pain. |
| |
| Foot/Ankle | Patients presenting with foot and ankle pain. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No intervention - retrospective observational cohort study | Other |
|
| Measure | Description | Time Frame |
|---|---|---|
| Long-term opioid use | opioid prescriptions for 3 months. | >90 days of opioid supply |
| Measure | Description | Time Frame |
|---|---|---|
| new long-term opioid use | Opioid prescriptions for over 3 months in patients who have not had prior opioid prescriptions. | >90 days of opioid supply |
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Inclusion Criteria:
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adult patients enrolled in private health insurance included within the Marketscan database, who generated at least one insurance claim for anorectal, foot/ankle, or TMJ pain.
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| ID | Term |
|---|---|
| D013001 | Somatoform Disorders |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
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