Association between Transient Opioid Use and Short-term Respiratory Exacerbation among Adults with Chronic Obstructive Pulmonary Disease (COPD): A Case-crossover Study.

This study aims to examine the association of transient or short-term opioid use and acute respiratory exacerbations among adults with COPD in Mississippi Medicaid. A case-crossover design was employed using 2013-2017 Mississippi Medicaid administrative claims data. The study found 1,972 qualifying exacerbation events occurring in 1,354 beneficiaries. The frequency and dose of opioid exposure in the seven days before the exacerbation were examined, and compared to the opioid exposure in ten control windows, each seven days long, before the exacerbation. Adjusted odds ratios (OR) were estimated using conditional logistic regression models to estimate the risk of opioid use on exacerbations after accounting for use of bronchodilators, corticosteroids, benzodiazepines, and β-blockers. Overall, opioid exposure in seven days before an exacerbation was significantly associated with acute respiratory exacerbation (OR: 1.81 [95% CI: 1.60, 2.05]). Each 25mg increase in morphine equivalent daily dose was found to be associated with an 11.2% increase in the odds of an acute respiratory exacerbation (OR: 1.11 [95% CI: 1.04, 1.20]). Transient use of opioids was significantly associated with acute respiratory exacerbation of COPD. PMID: 31361012 [PubMed - as supplied by publisher]
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research