Opioid Use and Healthcare Utilization in Adults With Psoriatic Arthritis and Ankylosing Spondylitis.

IF 3.6 2区 医学 Q2 RHEUMATOLOGY Journal of Rheumatology Pub Date : 2024-10-01 DOI:10.3899/jrheum.2024-0127
Jean W Liew, Sofia Pedro, Kaleb Michaud, Alexis Ogdie
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Abstract

Objective: Opioid use among individuals with spondyloarthritis is common; however, data on whether these individuals have higher utilization of the healthcare system are lacking. We examined the association between opioid use and healthcare utilization and costs among patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS).

Methods: We included adults with PsA or AS enrolled in the FORWARD registry, with ≥ 1 completed disease activity or disability questionnaire between 2010 and 2019. The exposure was patient-reported opioid use, and the outcomes were annualized healthcare utilization and prescription costs. We used negative binomial regression to assess the association between opioid use and the utilization outcomes, and generalized linear models with γ-distribution and log link function for the association between opioid use and costs. Models were adjusted for age, sex, and hospitalization. AS and PsA were studied separately.

Results: Among 828 patients with PsA, 21.4% used opioids; for those with AS, 27.2% of 334 patients reported opioid use. Opioid users had higher healthcare utilization and costs, including increased medical visits, diagnostic tests, direct medical costs, and pharmacy expenses. Opioid users had 32-33% more medical visits annually vs nonusers. Patients using opioids spent more on medical visits annually compared to nonusers (US $3464 vs $2706 for PsA; US $4500 vs $3660 for AS).

Conclusion: Compared to patients not using opioids, patients with PsA and AS who used opioids had higher healthcare utilization and higher health-related costs. New care pathways are needed to improve care and reduce costs.

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银屑病关节炎和强直性脊柱炎成人的阿片类药物使用和医疗保健使用情况。
目的:脊柱关节炎患者使用阿片类药物的情况很普遍,但这些患者是否会更多地使用医疗保健系统却缺乏相关数据。我们研究了银屑病关节炎(PsA)和强直性脊柱炎(AS)患者使用阿片类药物与医疗保健利用率和成本之间的关系:我们纳入了加入FORWARD登记册的PsA或AS成人患者,他们在2010年至2019年期间完成了≥1次疾病活动或残疾问卷调查。暴露是患者报告的阿片类药物使用情况,结果是年化医疗保健利用率和处方成本。我们使用负二项回归评估阿片类药物使用与使用结果之间的关系,并使用具有γ分布和对数连接功能的广义线性模型评估阿片类药物使用与费用之间的关系。模型根据年龄、性别和住院情况进行了调整。对AS和PsA分别进行了研究:在828名PsA患者中,21.4%使用阿片类药物;在334名AS患者中,27.2%报告使用阿片类药物。阿片类药物使用者的医疗保健使用率和成本较高,包括就诊次数、诊断检测、直接医疗成本和药房费用的增加。与不使用阿片类药物的患者相比,使用阿片类药物的患者每年就诊次数增加 32-33%。与不使用阿片类药物的患者相比,使用阿片类药物的患者每年的就诊费用更高(PsA患者为3464美元,AS患者为3660美元;PsA患者为3464美元,AS患者为2706美元):结论:与不使用阿片类药物的患者相比,使用阿片类药物的PsA和AS患者的医疗使用率更高,医疗相关费用也更高。需要新的护理路径来改善护理并降低成本。
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来源期刊
Journal of Rheumatology
Journal of Rheumatology 医学-风湿病学
CiteScore
6.50
自引率
5.10%
发文量
285
审稿时长
1 months
期刊介绍: The Journal of Rheumatology is a monthly international serial edited by Earl D. Silverman. The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 41 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.
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