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Abstract
Objective The goals of this study were to describe opioid and benzodiazepine prescribing practices in the gynecologic oncology patient population and determine risks for opioid misuse in these patients.
Methods Retrospective study of opioid and benzodiazepine prescriptions for patients treated for cervical, ovarian (including fallopian tube/primary peritoneal), and uterine cancers within a single healthcare system from January 2016 to August 2018.
Results A total of 7643 prescriptions for opioids and/or benzodiazepines were dispensed to 3252 patients over 5754 prescribing encounters for cervical (n=2602, 34.1%), ovarian (n=2468, 32.3%), and uterine (n=2572, 33.7%) cancer. Prescriptions were most often written in an outpatient setting (51.0%) compared with inpatient discharge (25.8%). Cervical cancer patients were more likely to have received a prescription in an emergency department or from a pain/palliative care specialist (p=0.0001). Cervical cancer patients were least likely to have prescriptions associated with surgery (6.1%) compared with ovarian cancer (15.1%) or uterine cancer (22.9%) patients. The morphine milligram equivalents prescribed were higher for patients with cervical cancer (62.6) compared with patients with ovarian and uterine cancer (46.0 and 45.7, respectively) (p=0.0001). Risk factors for opioid misuse were present in 25% of patients studied; cervical cancer patients were more likely to have at least one risk factor present during a prescribing encounter (p=0.0001). Cervical cancer was associated with a higher number of risk factors (p<0.001).
Conclusions Opioid and benzodiazepine prescribing patterns differ for cervical, ovarian, and uterine cancer patients. Gynecologic oncology patients are overall at low risk for opioid misuse; however, patients with cervical cancer are more likely to have risk factors present for opioid misuse.
- Opioid-Related Disorders
- Pain
- Cancer Pain
Data availability statement
Data are available upon reasonable request.
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Data availability statement
Data are available upon reasonable request.
Footnotes
Twitter @wendel_naumann
Collaborators PRIMUM Group: Michael Beuhler, MD; Michael J Bosse, MD; Michael Gibbs, MD; Christopher Griggs, MD; Ashu Gulati, MS; Steven Jarrett, PharmD; Daniel Leas, MD; Susan Odum, PhD; Tamar Roomian, MS, MPH; Michael Runyon, MD; Animita Saha, MD; D Matthew Sullivan, MD; Brad Watling, MD.
Contributors KL, SRP: responsible for manuscript preparation, data collection, study design, and revisions. ZY, MW: responsible for study design, statistical analysis, and data compilation. SO, JRH, RS: contributed to the study design, statistical analysis, and data collection. JB, WN: contributed to study design and manuscript preparation. WN: guarantor. The PRIMUM group is a group of authors responsible for establishing the database used in the study for collecting opioid prescribing data.
Funding This work was supported in part by a cooperative agreement (CE14-004 Award Number CE002520) from the Centers for Disease Control and Prevention and by an internal grant from the Carolinas Trauma Network Research Center of Excellence.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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