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Persistent Opioid Use After Cardiac Implantable Electronic Device Procedures.

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Persistent opioid use (POU) is common after cardiac implantable electronic device (CIED) procedures, affecting 12% of patients. Higher initial opioid doses increase the risk of developing POU.

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Area of Science:

  • Cardiology
  • Pain Management
  • Public Health

Background:

  • Prescription opioids contribute significantly to the persistent opioid use (POU) epidemic.
  • The incidence of POU in opioid-naïve patients following cardiac implantable electronic device (CIED) procedures remains unknown.

Purpose of the Study:

  • To determine the incidence of POU among opioid-naïve patients after CIED procedures.
  • To identify risk factors associated with POU in this patient population.

Main Methods:

  • Retrospective cohort study using a national administrative claims database (2004-2018).
  • Included opioid-naïve adult patients undergoing CIED procedures, excluding those with other procedures within 180 days.
  • Defined POU as opioid prescription fill >30 days post-CIED procedure.

Main Results:

  • 11% of 143,400 eligible patients received opioids within 14 days of CIED surgery.
  • POU occurred in 12.4% of these patients (30-180 days post-surgery).
  • Risk factors for POU included prior drug abuse, muscle relaxant/benzodiazepine use, and higher initial oral morphine equivalent doses (>135 mg).

Conclusions:

  • POU is a common outcome after CIED procedures, with 12% of patients continuing opioid use beyond 30 days.
  • Higher initial opioid prescription doses are linked to an increased risk of developing POU.