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• W2978595056 abstract "Introduction: Inflammatory bowel disease (IBD), mainly divided into Crohn's Disease (CD) and Ulcerative Colitis (UC), is commonly associated with pain. Recent studies have linked high dose (HD) opiate use with an increased risk of death in the IBD population. The mechanism of this association is undefined, and there has been no study examining the reason for opiate use in IBD patients. Our goal was to define the clinical indications of opiate use as a first step in formulating strategies to prevent or decrease usage. Methods: A retrospective case series was conducted including patients 18 years and older with an IBD diagnosis obtained from the outpatient electronic medical record of our health system. Patients were filtered for documented or prescribed opiate use, based on a minimum 30 day prescription in a 365 day span. They were further broken into low dose (LD) opiate users if < 50mg morphine equivalent prescribed daily, and HD users if ≥50mg. Individual chart notes were then reviewed to determine the clinical indication(s) for LD and HD use. Results: 3,226 subjects with IBD were found out of 1,109,277 patients between 2009-14. Of these, 104 had opiate use (57 female, 65 CD, mean age 53.64 ±18.27)for 134 indications. No significant trend for gender, age or disease type was noted for HD vs. LD users. IBD issues accounted for 49.25% of opiate indications, and abdominal pain was the most common reason cited (23.13%),Table 1. IBD related complaints overall (81.40% vs. 50.82% p=0.0014) and abdominal pain specifically (44.19% vs19.67% p=0.0071) were more common among HD vs LD users,Table 2. Only 11 patients had multiple prescriptions over time, with a median number of 5. These patients were more likely to be HD users (55.56% vs 44.44% p=0.048), with a majority reporting abdominal pain (54.54%).Table 1: Indications for Opioid Use: Complaint AnalysisTable 2: Indications for Opiate use: Patient analysisConclusion: Though opiate use in IBD is associated with co-morbidities such as smoking and psychiatric disease, the indications for use have been undefined. Our observations show that IBD complaints, especially abdominal pain account for most HD use. While it is unknown if HD use is directly harmful, we should assume it is. Since our retrospective study design precludes measuring IBD activity, it is unclear if directed IBD therapies alone are an adequate response to HD use. Future research should address non opiate pain management strategies for IBD related pain concurrent with an emphasis on early and highly effective IBD therapy to prevent the disease complications leading to opiate use." @default.
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• W2978595056 date "2015-10-01" @default.
• W2978595056 modified "2023-09-27" @default.
• W2978595056 title "Analysis of the Clinical Indications for Opiate Use in Inflammatory Bowel Disease" @default.
• W2978595056 doi "https://doi.org/10.14309/00000434-201510001-01856" @default.
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