A Nationwide Retrospective Study of Opioid Management Patterns in 2,468 Patients with Spinal Pain in Korea

• Published in: Asian spine journal Vol. 10; no. 6; pp. 1122 - 1131
• Main Authors: Chung, Sung-Soo, Park, Chun-Kun, Cho, Kyu-Jung, Choi, Kyoung Hyo, Kim, Jin-Hyok, Kim, Sung-Bum, Kuh, Sung-Uk, Lee, Jae Chul, Lee, Jae Hyup, Lee, Kyu-Yeol, Lee, Sun-Ho, Moon, Seong-Hwan, Park, Si-Young, Shim, Jae Hang, Son, Byung-Chul, Yoon, Myung Ha, Park, Hye-Jeong
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Spine Surgery 01.12.2016; Korean Spine Society; 대한척추외과학회
• Subjects: Ambulatory care; Analgesics; Back pain; Cancer therapies; Chronic pain; Clinical Study; Data collection; Drug dosages; Drug therapy; Fentanyl; Hospitals; Intervertebral discs; Medical records; Narcotics; Neuralgia; Nonsteroidal anti-inflammatory drugs; Opioid; Opioids; Oxycodone; Pain management; Pain perception; Patients; Questionnaires; Spinal diseases; Spinal stenosis; Spine; Standard deviation; Vertebrae; 정형외과학; United Kingdom > UK; United States > US; Opioid; Spine; Chronic pain; Spinal diseases
• ISSN: 1976-1902; 1976-7846
• DOI: 10.4184/asj.2016.10.6.1122

Retrospective patient data collection and investigator survey. To investigate patterns of opioid treatment for pain caused by spinal disorders in Korea. Opioid analgesic prescription and adequacy of consumption measures in Korea have markedly increased in the past decade, suggesting changing patterns in pain management practice; however, there is lack of integrated data specific to Korean population. Patient data were collected from medical records at 34 university hospitals in Korea. Outpatients receiving opioids for pain caused by spinal disorders were included in the study. Treatment patterns, including opioid types, doses, treatment duration, outcomes, and adverse drug reactions (ADRs), were evaluated. Investigators were interviewed on their perceptions of opioid use for spinal disorders. Among 2,468 analyzed cases, spinal stenosis (42.8%) was the most common presentation, followed by disc herniation (24.2%) and vertebral fracture (17.5%). In addition, a greater proportion of patients experienced severe pain (73.9%) rather than moderate (19.9%) or mild (0.7%) pain. Oxycodone (51.9%) and fentanyl (50.8%) were the most frequently prescribed opioids; most patients were prescribed relatively low doses. The median duration of opioid treatment was 84 days. Pain relief was superior in patients with longer treatment duration (≥2 months) or with nociceptive pain than in those with shorter treatment duration or with neuropathic or mixed-type pain. ADRs were observed in 8.6% of cases. According to the investigators' survey, "excellent analgesic effect" was a perceived advantage of opioids, while safety concerns were a disadvantage. Opioid usage patterns in patients with spinal disorders are in alignment with international guidelines for spinal pain management. Future prospective studies may address the suitability of opioids for spinal pain treatment by using appropriate objective measurement tools.