Table 1-.
Patient-level descriptive statistics and opioid use characteristics in the year leading up to total joint replacement in a cohort of severe osteoarthritis patients among opioid non-users, short-term users (<90 days) and long-term users (≥90 days), Medicare data 2010–2014
| Non-users | Short-term users | Long-term users | |
|---|---|---|---|
| Total patients | 146426 | 152308 | 59387 |
| Patient characteristics | |||
| Average age ± SD | 74.3 (5.9) | 73.9 (5.9) | 73.5 (6.1) |
| Male gender (n (%)) | 52480 (35.8) | 48661 (31.9) | 14421 (24.3) |
| White race (n (%)) | 136213 (93.0) | 139730 (91.7) | 53119 (89.4) |
| Medicare-Medicaid dually eligible (n (%)) | 12089 (8.3) | 17929 (11.8) | 15017 (25.3) |
| Type of total joint replacement surgery | |||
| Total knee replacement (n (%)) | 105188 (71.8) | 101159 (66.4) | 37827 (63.7) |
| Total hip replacement (n (%)) | 41238 (28.2) | 51149 (33.6) | 21560 (36.3) |
| Pain related diagnoses and other comorbid conditions | |||
| Rheumatoid arthritis (n (%)) | 4603 (3.1) | 7374 (4.8) | 5862 (9.9) |
| Neuropathic pain (n (%)) | 29244 (20.0) | 49911 (32.8) | 27106 (45.6) |
| Back pain (n (%)) | 57840 (39.5) | 84146 (55.2) | 42393 (71.4) |
| Migraine (n (%)) | 8911 (6.1) | 14375 (9.4) | 8062 (13.6) |
| Falls (n (%)) | 4809 (3.3) | 9664 (6.3) | 6071 (10.2) |
| Fractures (n (%)) | 7209 (4.9) | 14549 (9.6) | 7799 (13.1) |
| Anxiety (n (%)) | 10980 (7.5) | 17579 (11.5) | 12027 (20.3) |
| Depression (n (%)) | 14165 (9.7) | 23163 (15.2) | 16212 (27.3) |
| Drug abuse (n (%)) | 67 (0) | 192 (0.1) | 506 (0.9) |
| Bipolar disorder (n (%)) | 988 (0.7) | 1505 (1) | 1268 (2.1) |
| Alcohol abuse (n (%)) | 919 (0.6) | 1468 (1) | 1003 (1.7) |
| Average omorbidity score ± SD | 0.6 (1.6) | 0.8 (1.8) | 1.3 (2.1) |
| Opioid use characteristics | |||
| Day supply of prescription opioids (Median, interquartile range) | - | 15 (6–34) | 218 (142–307) |
| Average daily dose of opioids in morphine mg equivalents (Median, interquartile range) | - | 30 (20–42.9) | 27.3 (17.8–41.7) |
| Average daily dose categories (n (%)) | - | ||
| <50 morphine mg equivalents | - | 128145 (84.1) | 48106 (81.0) |
| 50–90 morphine mg equivalents | - | 19911 (13.1) | 6836 (11.5) |
| >=90 morphine mg equivalents | - | 4252 (2.8) | 4445 (7.5) |
| Total number of different agents used (Median, interquartile range) | - | 1 (1–2) | 2 (1–2) |
| Five most commonly used agents | - | ||
| Tramadol | - | 55968 (36.8) | 27224 (45.8) |
| Hydrocodone | - | 58134 (38.2) | 17793 (30.0) |
| Oxycodone | - | 32998 (21.7) | 19154 (32.2) |
| Propoxyphene | - | 3018 (2.0) | 1953 (3.3) |
| Fentanyl | - | 731 (0.5) | 3671 (6.2) |