P216 - WHAT IS THE RATE OF CHRONIC OPIOID USE AND HOW IT IMPACTS HEALTHCARE UTILIZATION WITHIN AN IBD CLINIC POPULATION
19 Jan 18
5:30 PM
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7:00 PM
Background: Opioid analgesics are frequently used to manage chronic abdominal pain in inflammatory bowel disease (IBD). We sought to quantify opioid use within the IBD clinic at the University of Kentucky and describe the impact it has on healthcare utilization and disease course. Methods: We retrospectively reviewed all patients seen in the IBD clinic that had received at least one outpatient opioid prescription over a period of 34 months. Data was obtained from the Kentucky drug monitoring system report. COU was defined as having at least a 90 day opioid supply within a 6 month period without any 30 day gaps. We collected data on biologic use, steroid courses, emergency department (ED) visits, readmissions, surgeries and CT or MRI scans over this period and calculated composite utilization scores. Results: A total of 740 patients were seen in the IBD clinic over the period. 23.8% were prescribed opioids at least once and 10.1% fulfilled the definition of COU. The mean opioid prescriptions per patient was 18.4 ± 20. Patients with COU were significantly more likely to obtain opioids from ≥4 prescribers and pharmacies (p= 0.0003) and be diagnosed with psychiatric disease (0.0095), than patients without COU. Furthermore, patients with COU had more than double the average number of ED visits (3.8 vs. 1.4, p=0.0125), CT or MRI scans (4.0 vs. 1.5, p= 0.0007) and a higher composite utilization score (23.9 vs. 14.5, p= 0.041) than patients without COU. Conclusion: The rate of chronic opioid use among our IBD clinic patients is alarmingly high. The patient on chronic opioids is more likely to obtain analgesics from several different providers and pharmacies and be diagnosed with psychiatric disease; Providers should be aware of these red flags. Patients with COU had more than double the number of ED visits and CT/MRI scans compared to non-chronic users. In the future, we should consider alternative options for analgesia and involving addiction and pain specialists.