Opioid exposure in haemophilia patients is common and underreported

Skye J Peltier; Marshall A Mazepa; Rebecca L Freese; Shannon F Nelson; Susan L Kearney; Mark T Reding

doi:10.1111/hae.13950

Opioid exposure in haemophilia patients is common and underreported

Skye J Peltier, Marshall A Mazepa, Rebecca L Freese, Shannon F Nelson, Susan L Kearney, Mark T Reding

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2 Scopus citations

Abstract

INTRODUCTION: In an era of increased opioid awareness, data on opioid exposure in haemophilia patients are lacking.

AIM: The objectives of this study were to (a) provide a detailed description of opioid exposure in haemophilia patients based on written prescription data, (b) compare our findings to national haemophilia-specific and general population datasets and (c) identify predictors of opioid exposure in haemophilia patients.

METHODS: Medical records of 183 adult and 135 paediatric patients from two haemophilia treatment centres (HTC) were reviewed over a 42-month period. Chronic exposure and acute opioid exposure were recorded, and results were compared to national haemophilia (ATHNdataset) and general population (CDC) data.

RESULTS: We found that 56% of adult and 21% of paediatric patients were exposed to opioids, rates substantially higher than reported in the ATHNdataset (6%) and national population data from the CDC. In adults, but not children, severity of haemophilia was a significant predictor of opioid exposure. Most acute opioid prescriptions were not written by the HTC.

CONCLUSIONS: This is the first study in the haemophilia population to examine opioid exposure based on prescription data. Opioid exposure was more common than predicted in both adult and paediatric study populations and was most often prescribed for acute pain or procedures by non-HTC providers. Haemophilia treatment centres need to take the lead in assessing pain in haemophilia patients, guiding treatment promoting non-opioid options, strengthen efforts to monitor opioid exposure and collect data on pain treatment in the haemophilia population.

Original language	English (US)
Pages (from-to)	251-256
Number of pages	6
Journal	Haemophilia
Volume	26
Issue number	2
DOIs	https://doi.org/10.1111/hae.13950
State	Published - Mar 1 2020

Bibliographical note

Funding Information:
Access to ATHNdataset and financial support through ATHN CARE award, Skye Peltier MPH, PA‐C. ATHN statistical support from Dunlei Cheng, PhD, Director of Biostatistics, ATHN. Study data were collected and managed using REDCap electronic data capture tools hosted at University of Minnesota and Children's Hospitals and Clinics of Minnesota. This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences.

Publisher Copyright:
© 2020 John Wiley & Sons Ltd

Keywords

adult
haemophilia A
haemophilia B
opioids
paediatric
pain

PubMed: MeSH publication types

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10.1111/hae.13950

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title = "Opioid exposure in haemophilia patients is common and underreported",

abstract = "INTRODUCTION: In an era of increased opioid awareness, data on opioid exposure in haemophilia patients are lacking.AIM: The objectives of this study were to (a) provide a detailed description of opioid exposure in haemophilia patients based on written prescription data, (b) compare our findings to national haemophilia-specific and general population datasets and (c) identify predictors of opioid exposure in haemophilia patients.METHODS: Medical records of 183 adult and 135 paediatric patients from two haemophilia treatment centres (HTC) were reviewed over a 42-month period. Chronic exposure and acute opioid exposure were recorded, and results were compared to national haemophilia (ATHNdataset) and general population (CDC) data.RESULTS: We found that 56% of adult and 21% of paediatric patients were exposed to opioids, rates substantially higher than reported in the ATHNdataset (6%) and national population data from the CDC. In adults, but not children, severity of haemophilia was a significant predictor of opioid exposure. Most acute opioid prescriptions were not written by the HTC.CONCLUSIONS: This is the first study in the haemophilia population to examine opioid exposure based on prescription data. Opioid exposure was more common than predicted in both adult and paediatric study populations and was most often prescribed for acute pain or procedures by non-HTC providers. Haemophilia treatment centres need to take the lead in assessing pain in haemophilia patients, guiding treatment promoting non-opioid options, strengthen efforts to monitor opioid exposure and collect data on pain treatment in the haemophilia population.",

keywords = "adult, haemophilia A, haemophilia B, opioids, paediatric, pain",

author = "Peltier, {Skye J} and Mazepa, {Marshall A} and Freese, {Rebecca L} and Nelson, {Shannon F} and Kearney, {Susan L} and Reding, {Mark T}",

note = "Funding Information: Access to ATHNdataset and financial support through ATHN CARE award, Skye Peltier MPH, PA‐C. ATHN statistical support from Dunlei Cheng, PhD, Director of Biostatistics, ATHN. Study data were collected and managed using REDCap electronic data capture tools hosted at University of Minnesota and Children's Hospitals and Clinics of Minnesota. This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences. Publisher Copyright: {\textcopyright} 2020 John Wiley & Sons Ltd",

year = "2020",

month = mar,

day = "1",

doi = "10.1111/hae.13950",

language = "English (US)",

volume = "26",

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journal = "Haemophilia",

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T1 - Opioid exposure in haemophilia patients is common and underreported

AU - Peltier, Skye J

AU - Mazepa, Marshall A

AU - Freese, Rebecca L

AU - Nelson, Shannon F

AU - Kearney, Susan L

AU - Reding, Mark T

N1 - Funding Information: Access to ATHNdataset and financial support through ATHN CARE award, Skye Peltier MPH, PA‐C. ATHN statistical support from Dunlei Cheng, PhD, Director of Biostatistics, ATHN. Study data were collected and managed using REDCap electronic data capture tools hosted at University of Minnesota and Children's Hospitals and Clinics of Minnesota. This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences. Publisher Copyright: © 2020 John Wiley & Sons Ltd

PY - 2020/3/1

Y1 - 2020/3/1

N2 - INTRODUCTION: In an era of increased opioid awareness, data on opioid exposure in haemophilia patients are lacking.AIM: The objectives of this study were to (a) provide a detailed description of opioid exposure in haemophilia patients based on written prescription data, (b) compare our findings to national haemophilia-specific and general population datasets and (c) identify predictors of opioid exposure in haemophilia patients.METHODS: Medical records of 183 adult and 135 paediatric patients from two haemophilia treatment centres (HTC) were reviewed over a 42-month period. Chronic exposure and acute opioid exposure were recorded, and results were compared to national haemophilia (ATHNdataset) and general population (CDC) data.RESULTS: We found that 56% of adult and 21% of paediatric patients were exposed to opioids, rates substantially higher than reported in the ATHNdataset (6%) and national population data from the CDC. In adults, but not children, severity of haemophilia was a significant predictor of opioid exposure. Most acute opioid prescriptions were not written by the HTC.CONCLUSIONS: This is the first study in the haemophilia population to examine opioid exposure based on prescription data. Opioid exposure was more common than predicted in both adult and paediatric study populations and was most often prescribed for acute pain or procedures by non-HTC providers. Haemophilia treatment centres need to take the lead in assessing pain in haemophilia patients, guiding treatment promoting non-opioid options, strengthen efforts to monitor opioid exposure and collect data on pain treatment in the haemophilia population.

AB - INTRODUCTION: In an era of increased opioid awareness, data on opioid exposure in haemophilia patients are lacking.AIM: The objectives of this study were to (a) provide a detailed description of opioid exposure in haemophilia patients based on written prescription data, (b) compare our findings to national haemophilia-specific and general population datasets and (c) identify predictors of opioid exposure in haemophilia patients.METHODS: Medical records of 183 adult and 135 paediatric patients from two haemophilia treatment centres (HTC) were reviewed over a 42-month period. Chronic exposure and acute opioid exposure were recorded, and results were compared to national haemophilia (ATHNdataset) and general population (CDC) data.RESULTS: We found that 56% of adult and 21% of paediatric patients were exposed to opioids, rates substantially higher than reported in the ATHNdataset (6%) and national population data from the CDC. In adults, but not children, severity of haemophilia was a significant predictor of opioid exposure. Most acute opioid prescriptions were not written by the HTC.CONCLUSIONS: This is the first study in the haemophilia population to examine opioid exposure based on prescription data. Opioid exposure was more common than predicted in both adult and paediatric study populations and was most often prescribed for acute pain or procedures by non-HTC providers. Haemophilia treatment centres need to take the lead in assessing pain in haemophilia patients, guiding treatment promoting non-opioid options, strengthen efforts to monitor opioid exposure and collect data on pain treatment in the haemophilia population.

KW - adult

KW - haemophilia A

KW - haemophilia B

KW - opioids

KW - paediatric

KW - pain

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JO - Haemophilia

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SN - 1351-8216

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Opioid exposure in haemophilia patients is common and underreported

Abstract

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