Asian Spine J.  2016 Dec;10(6):1122-1131. 10.4184/asj.2016.10.6.1122.

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

• Chung SS
• Park CK
• Cho KJ
• Choi KH
• Kim JH
• Kim SB
• Kuh SU
• Lee JC
• Lee JH
• Lee KY
• Lee SH
• Moon SH
• Park SY
• Shim JH
• Son BC
• Yoon MH
• Park HJ

• KMID: 2362192
• DOI: http://doi.org/10.4184/asj.2016.10.6.1122

Abstract

STUDY DESIGN: Retrospective patient data collection and investigator survey. PURPOSE: To investigate patterns of opioid treatment for pain caused by spinal disorders in Korea. OVERVIEW OF LITERATURE: 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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.

Keyword

Spine; Spinal diseases; Chronic pain; Opioid

MeSH Terms

Analgesics, Opioid
Chronic Pain
Data Collection
Drug-Related Side Effects and Adverse Reactions
Fentanyl
Hospitals, University
Humans
Korea*
Medical Records
Nociceptive Pain
Outpatients
Oxycodone
Pain Management
Prescriptions
Prospective Studies
Research Personnel
Retrospective Studies*
Spinal Diseases
Spinal Stenosis
Spine
Analgesics, Opioid
Fentanyl
Oxycodone