Opioid prescribing trends and pain scores among adult patients with cancer in a large health system

Abstract

Background: Opioid stewardship policies could adversely affect pain management for patients with cancer. Yet patients with cancer are also at risk for opioid-related harms. This study sought to determine trends in opioid prescribing by clinical stratum and pain for patients with cancer from 2016 to 2020. Methods: A retrospective study was conducted of opioid-naive adults with newly diagnosed cancer from 2016 to 2020 (N = 10,232) in a large Connecticut health system. Logistic regression was used to calculate changes in the predicted probability of opioid prescribing from 2016 to 2020. Two subpopulations were examined: patients treated surgically (n = 4405) and patients with metastatic cancer (n = 2158). Flowsheet pain scores for patients with metastatic cancer were used to stratify by no pain (all scores, 0) versus any pain. The main outcomes were new (≥1 prescription in the 0–6 months after diagnosis) and additional (0–6 and 7–9 months) opioid prescriptions. Results: A decline was observed in the predicted probability of new (71.1% to 64.6%; p