Anxiety, sleep disturbance may be predictors of high barriers to proper opioid use
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CHICAGO — Results presented at the North American Spine Society Annual Meeting showed anxiety and sleep disturbance were independent predictors of high barriers to proper opioid use after spinal deformity surgery.
Arjun Gupta, BS, and colleagues retrospectively reviewed preoperative patient-reported outcome measurement information system (PROMIS) questionnaires, Barriers Questionnaire-Taiwan (S-BQT) and preoperative opioid use behaviors among 106 patients undergoing spinal deformity surgery with at least five levels fused and compared characteristics of patients with high barriers to proper opioid use to patients with low to normal barriers to proper opioid use. Researchers performed a Bayesian threshold regression analysis to identify a PROMIS score threshold that may predict high barriers of proper opioid use. They also used a multivariable logistic regression model to determine if there were any associations between the thresholds identified to barriers of proper opioid use while controlling for baseline characteristics.
“Overall, 22% were classified as having high barriers to proper opioid use and just to give you an idea of what this looked like, some of the most common barriers were a fear of addiction, concern that pain was a sign of disease progression and belief that pain medication should be saved until the pain becomes bad,” Gupta said.
Gupta noted patients with high barriers to proper opioid use were more likely to be older, live alone and have fewer comorbidities overall compared with patients with low to normal barriers to proper opioid use.
“Surprisingly, we found there was no difference in terms of opioid naivety or opioid use within the last 30 days before surgery,” Gupta said.
Patients with high barriers to proper opioid use had worse pain interference, physical function, fatigue, anxiety, sleep disturbance and dissatisfaction with social roles on the PROMIS questionnaire, according to Gupta. Bayesian threshold regression analysis showed anxiety and sleep disturbance were likely to be predictive of high barriers to proper opioid use.
“When we performed the multivariable regression analysis using these thresholds, we found that the odds that these thresholds could predict high barriers to proper opioid use were considerably high,” Gupta said. “For anxiety scores, it was an odds ratio of 4.5 and, for sleep disturbance, an odds ratio of 6.2.”
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Mo K, et al. Paper 149. Presented at: North American Spine Society Annual Meeting; Oct. 12-15, 2022; Chicago.
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