Persistent Opioid Use Among the Elderly After Lung Resection: A SEER-Medicare Study

Area of Science:

• Oncology
• Pain Management
• Health Services Research

Background:

• Opioids are primary treatments for postsurgical pain but carry risks of morbidity and dependency.
• Lung cancer surgery necessitates effective pain management strategies.
• Understanding persistent opioid use is crucial for patient outcomes.

Purpose of the Study:

• To determine the incidence of persistent opioid use following lung resection surgery.
• To identify predictors of persistent opioid use in lung cancer patients.
• To evaluate the impact of surgical approach on long-term opioid utilization.

Main Methods:

• Retrospective cohort study using the Surveillance, Epidemiology and End Results-Medicare database (2008-2013).
• Identified patients who underwent lung resection for non-small cell lung cancer.
• Categorized patients into preoperative opioid user groups (naïve, intermittent, chronic) and defined persistent use as opioid prescriptions filled 3-6 months post-surgery.

Main Results:

• Persistent opioid use was observed in 31% of 6948 patients, including 17% of opioid-naïve individuals.
• Predictors for persistent use in opioid-naïve patients included adjuvant therapy, younger age (<70), moderate comorbidity score (Charlson 1-2), and lower socioeconomic status.
• Minimally invasive surgery was linked to a lower likelihood of persistent opioid use.

Conclusions:

• Persistent opioid dependence after lung resection is a significant issue, particularly in older populations.
• Minimally invasive surgical techniques may reduce the incidence of persistent opioid use.
• Further research into opioid-sparing strategies post-lung surgery is warranted.