Anxiety, sleep disturbances can predict major barriers to proper opioid use

November 17, 2022

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Source/information

Source:

Mo K, et al. Paper 149. Presented at: North American Spine Society Annual Meeting; October 12-15, 2022; Chicago.

Disclosures:
Gupta reports no relevant financial information.


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CHICAGO – Findings presented at the North American Spine Society’s annual meeting showed that anxiety and sleep disturbances were independent predictors of major barriers to appropriate opioid use after spinal deformity.

Arjun GuptaBS, and colleagues retrospectively examined the preoperative patient-reported outcome measure (PROMIS) questionnaire, the Barriers Questionnaire-Taiwan (S-BQT), and preoperative opioid use among 106 patients undergoing spinal deformity surgery with at least five levels combined and compared patients’ symptoms of high barriers to proper opioid use for patients with low to normal barriers to proper opioid use. The researchers conducted a Bayesian threshold regression analysis to identify a PROMIS score threshold that could predict high barriers to proper opioid use. They also used a multivariate regression model to determine if there was any relationship between thresholds of reported barriers to proper opioid use while controlling for baseline symptoms.

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“Overall, 22% were classified as having high barriers to proper opioid use, and just to give you an idea of ​​what that looked like, some of the most common barriers were fear of addiction, concern that pain is a sign of disease progression, and believing that painkillers should not be kept until the pain gets bad,” said Gupta.

Arjun Gupta

Arjun Gupta

Gupta noted that patients with high barriers to proper opioid use were more likely to be older, live alone, and have fewer comorbidities overall compared to patients with low to moderate barriers to proper opioid use.

“Surprisingly, we found that there was no difference in opioid naïveté or opioid use in the last 30 days before surgery,” Gupta said.

Patients with high barriers to proper opioid use had worse pain, physical function, fatigue, anxiety, sleep disturbances and dissatisfaction with social roles on the PROMIS questionnaire, according to Gupta. Bayesian thresholds regression analysis showed that anxiety and sleep disturbances were likely predictors of high barriers to proper opioid use.

“When we did the multivariate regression analysis with these thresholds, we found that the likelihood that these thresholds would predict high barriers to proper opioid use was quite high,” Gupta said. “For anxiety levels, the odds were 4.5 and for sleep disorders 6.2.”

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