Thoracotomy, Adjuvant Therapy Increase Risk for Opioid Use After Lung Resection

Opioid-naive patients with cancer undergoing lung resection were more likely to continue refilling opioid prescriptions between 3 and 6 months after surgery if they underwent thoracotomy or had adjuvant chemotherapy, according to the results of a study published in the Annals of Thoracic Surgery.

Prescription opioid refill claims were evaluated from the Truven Health MarketScan Databases 3 to 6 months after surgery for opioid-naive patients with cancer undergoing lung resection. Associations and risk factors were determined from individuals who continued opioid use, and compared between groups.

Of the 3026 opioid-naive patients with cancer undergoing lung resection, 6.5% underwent neoadjuvant therapy, whereas 21.7% underwent adjuvant therapy. Furthermore, 3 to 6 months after surgery, 14% of patients continued to fill opioid prescriptions. After analysis, being 64 years old or younger (odds ratio [OR], 1.30), being male (OR, 1.39), having underwent a thoracotomy (OR, 1.58), and using adjuvant therapy (OR, 2.19) were all associated with a greater risk for persistent opioid use.

The researchers wrote that these results necessitate “further studies to elucidate risk factors associated with persistent opioid usage, prioritizing and establishing standard protocols for patient education and safe disposal of excess medications, and development and implementation of evidence-based opioid prescribing guidelines.”

Reference

Brescia A, Harrington C, Mazurek A, et al. Factors associated with new persistent opioid usage after lung resection [published online October 11, 2018] Ann Thorac Surg. doi:10.1016/j.athoracsur.2018.08.057