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The prevalence and economic impact of prescription opioid-related side effects among patients with chronic noncancer pain

Jasmina I. Ivanova, MA, Howard G. Birnbaum, PhD, Yana Yushkina, BA, Rachael A. Sorg, MPH, John Reed, MD, Sanjay Merchant, MBA, PhD


Objectives: To estimate the prevalence of opioid-related side effects among patients with chronic noncancer pain (CNCP) who initiated opioids and compare healthcare costs of patients with and without side effects using patient survey, medical charts, and claims data.

Patients, participants: Patients initiating opioids, who were aged 18 years, had 1 pain diagnosis, and did not have cancer, were identified through claims data and medical records from a Central Massachusetts medical group practice and mailed surveys between October 2010 and July 2012.

Main outcomes measures: Prevalence of opioid-related side effects was estimated from patient surveys, charts, and claims data within 90 days after opioid initiation (study period). Study period healthcare costs were compared between patients with and without side effects (self-reported problematic side effects or side effects recorded in medical charts or claims).

Results: Among patients with CNCP who initiated opioids and completed the survey (N = 167), the average age was 53 years, and 62.9 percent were women. Based on the survey, charts, and claims, 91.6 percent, 15.0 percent, and 19.2 percent of patients, respectively, had 1 opioid-related side effect. Overall, 59.3 percent of patients reported having 1 problematic side effect or side effect recorded in charts or claims. In the analysis that controlled for baseline characteristics and resource use, patients with versus without side effects had higher mean study period healthcare costs ($3,347 vs $2,521, p = 0.049).

Conclusions: Prevalence of opioid-related side effects among patients with CNCP who initiated opioids was substantially higher based on patient survey than from charts or claims. Opioid-related side effects were associated with significantly higher healthcare costs.


chronic noncancer pain, prescription opioids, opioid-related side effects, prevalence, resource use, costs

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