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dc.contributor.authorHolmberg, Siril T.
dc.contributor.authorSkurtveit, Svetlana
dc.contributor.authorGulati, Sasha
dc.contributor.authorSalvesen, Øyvind
dc.contributor.authorNygaard, Øystein P.
dc.contributor.authorSolberg, Tore K.
dc.contributor.authorFredheim, Olav M. S.
dc.date.accessioned2024-03-21T09:21:43Z
dc.date.available2024-03-21T09:21:43Z
dc.date.issued2023-07-15
dc.description.abstractStudy Design - Prospective pharmacoepidemiologic study.<p> <p>Objective - To investigate clinical and sociodemographic factors associated with persistent opioid use in the years following spine surgery among patients with persistent opioid use preceding lumbar spine surgery.<p> <p>Summary of Background Data - It is unknown whether successful spine surgery leads to a cessation of preoperative persistent opioid use.<p> <p>Materials and Methods - Data from the Norwegian Registry for Spine Surgery and the Norwegian Prescription Database were linked for patients operated for degenerative lumbar spine disorders between 2007 and 2017. The primary outcome measure was persistent opioid use in the second year after surgery. Functional disability was measured with the Oswestry Disability Index (ODI). Factors associated with persistent opioid use in the year before, and two years following, surgery were identified using multivariable logistic regression analysis. The variables included in the analysis were selected based on their demonstrated role in prior studies.<p> <p>Results - The prevalence of persistent opioid use was 8.7% in the year before surgery. Approximately two-thirds of patients also met the criteria for persistent opioid use the second year after surgery. Among patients who did not meet the criteria for persistent opioid use the year before surgery, 991 (3.3%) patients developed persistent opioid use in the second year following surgery. The strongest association was exhibited by high doses of benzodiazepines in the year preceding surgery (OR 1.7, 95% CI 1.26 to 2.19, P<0.001). Among patients without persistent opioid use, the most influential factor associated with new-onset persistent opioid use in the second year after surgery was the use of high doses of benzodiazepines (OR 1.8, 95% CI 1.26 to 2.44, P<0.001), high doses of z-hypnotics (OR 2.6, 95% CI 2.10 to 3.23, P<0.001) and previous surgery at the same lumbar level (OR 1.37, 95% CI 1.11 to 1.68, P=0.003).<p> <p>Conclusion - A substantial proportion of patients reported sustained opioid use after surgery. Patients with persistent opioid use before surgery should be supported to taper off opioid treatment. Special efforts appear to be required to taper off opioid use in patients using high doses of benzodiazepines.<p> <p>Level of Evidence - 2; Prospective observational study.en_US
dc.identifier.citationHolmberg, Skurtveit, Gulati, Salvesen, Nygaard, Solberg, Fredheim. Persistent Use of Prescription Opioids Before and After Lumbar Spine Surgery: Observational Study With Prospectively Collected Data From Two Norwegian National Registries. Spine. 2023;48(14):969-977en_US
dc.identifier.cristinIDFRIDAID 2147597
dc.identifier.doi10.1097/BRS.0000000000004710
dc.identifier.issn0362-2436
dc.identifier.issn1528-1159
dc.identifier.urihttps://hdl.handle.net/10037/33209
dc.language.isoengen_US
dc.publisherLippincott, Williams & Wilkinsen_US
dc.relation.journalSpine
dc.relation.projectIDNorges forskningsråd: 320360en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.titlePersistent Use of Prescription Opioids Before and After Lumbar Spine Surgery: Observational Study With Prospectively Collected Data From Two Norwegian National Registriesen_US
dc.type.versionacceptedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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