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Impact of constipation on opioid use patterns, health care resource utilization, and costs in cancer patients on opioid therapy
Journal Of Pain & Palliative Care Pharmacotherapy, 08/10/09

Candrilli SD et al. – In a trial to assess the impact of constipation on opioid use patterns, health care resource utilization, and costs in cancer pts on opioid therapy, this study suggests that in opioid-treated cancer pts, constipation significantly impacts opioid-use patterns, resource utilization, and costs. Alleviation of constipation may optimize opioid therapy and reduce costs.

Methods

Patterns of opioid use, resource utilization, and costs in cancer pts with and without constipation were compared using retrospective insurance claims data.
Inclusion criteria were ≥30 days of opioid use and continuous plan coverage for ≥6 mos before and ≥12 mos following first opioid claim (index date).
Constipation was defined as ≥1 ICD-9-CM diagnosis codes in the range of 564.0x during the 12 mos postindex date.

Results

Of the 8836 opioid initiators with cancer initially considered, approximately 9.3% (n=821) had a diagnosis of constipation during follow-up.
Opioid use patterns were compared between pts with constipation and matched controls.
2-part semilogarithmic regression models assessed the impact of constipation on resource utilization and associated costs.
Compared with controls without constipation, pts with constipation had higher rates of concurrent use of ≥2 opioids, opioid discontinuation, opioid switching, nausea with vomiting, and respiratory depression.
Compared with controls, more pts with constipation received inpatient, hospice, home health, laboratory, other outpatient, emergency, office visit, and nursing home care.
Compared with controls, pts with constipation had substantially higher total costs.

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