Table 1.
Characteristics in the Initial 12-Month LTOT Episode of Beneficiaries with LTOT Use, by Discontinuation Status
| Characteristics in initial 12-month LTOT episode | All LTOT users N = 258,988 | Continuous LTOT users N = 241,371 |
Discontinued users N = 17,617 | aOR for discontinuation | p value |
|---|---|---|---|---|---|
| Age in years (mean, SD) | 60.3 (12.6) |
60.4 (12.6) |
58.4 (13.7) |
0.99 | p < 0.001 |
| Gender | |||||
| Male | 109,045 (42.1%) | 100,611 (41.7%) | 8434 (47.9%) | Ref. | - |
| Female | 149,943 (57.9%) | 140,760 (58.3%) | 9183 (52.1%) | 0.78 | p < 0.001 |
| Race | |||||
| Non-white | 46,666 (18%) | 43,403 (18%) | 3263 (18.5%) | Ref. | - |
| White race | 210,711 (81.4%) | 196,447 (81.4%) | 14,264 (81%) | 1.04 | 0.100 |
| Original reason for Medicare enrollment | |||||
| Age and survivors insurance | 74,385 (28.7%) | 69,916 (29%) | 4469 (25.4%) | Ref. | - |
| Disability | 182,196 (70.3%) | 169,206 (70.1%) | 12,990 (73.7%) | 0.90 | p < 0.001 |
| ESRD | 980 (.4%) | 915 (.4%) | 65 (.4%) | 0.75 | 0.031 |
| Both ESRD and disability | 1427 (.6%) | 1334 (.6%) | 93 (.5%) | 0.75 | 0.009 |
| Enrolled in Medicaid | |||||
| No | 135,892 (52.5%) | 127,688 (52.9%) | 8204 (46.6%) | Ref. | - |
| Yes | 123,096 (47.5%) | 113,683 (47.1%) | 9413 (53.4%) | 1.19 | p < 0.001 |
| Enrolled in Medicare Advantage | |||||
| No | 145,866 (56.3%) | 135,829 (56.3%) | 10,037 (57%) | Ref. | - |
| Yes | 113,122 (43.7%) | 105,542 (43.7%) | 7580 (43%) | 1.01 | 0.504 |
| Chronic condition count (mean, SD) |
2.9 (2.9) |
2.9 (2.9) |
2.8 (2.9) |
0.99 | 0.041 |
| Distribution of avg. daily MME | |||||
| 26–50 | 135,521 (52.3%) | 125,732 (52.1%) | 9789 (55.6%) | Ref. | - |
| 51–100 | 66,380 (25.6%) | 62,000 (25.7%) | 4380 (24.9%) | 0.87 | p < 0.001 |
| 101–200 | 35,184 (13.6%) | 32,896 (13.6%) | 2288 (13%) | 0.83 | p < 0.001 |
| 201+ | 21,903 (8.5%) | 20,743 (8.6%) | 1160 (6.6%) | 0.64 | p < 0.001 |
| Median no. of total MME of opioids (IQR) |
17,400 (12,195–32,670) |
17,490 (12,232.50–32,850) |
16,432.66 (11,755–29,877.27) |
||
| Average daily dose > 90 MME | 64,165 (24.8%) | 60,241 (25%) | 3924 (22.3%) | ||
| Median no. of days supplied (IQR) |
340 (322–354) |
340 (322–354) |
336 (319–351) |
||
aOR, adjusted odds ratio; MME, morphine milligrams equivalent; IQR, interquartile range. Adjusted odds ratio estimated using multivariable logistic regression controlling for the patient characteristics in the table and fixed effects for state. The adjusted odds ratio for age is for each additional year in age, and the odds ratio for chronic condition count is for each additional chronic condition. The chronic conditions included are acquired hyperthyroidism, acute myocardial infarction, Alzheimer’s disease and related disorders or senile dementia, anemia, asthma, atrial fibrillation, benign prostatic hyperplasia, cataract, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, depression, heart failure, glaucoma, hip/pelvic fracture, hyperlipidemia, hypertension, ischemic heart disease, osteoporosis, rheumatoid arthritis/osteoarthritis, and stroke or transient ischemic attack. Chronic conditions related to cancer (breast cancer, colorectal cancer, prostate cancer, lung cancer, endometrial cancer) were not present because they were excluded from the study sample