OBJECTIVES

The objective of this study was to assess patterns of short-acting (SAO) and long-acting (LAO) opioid utilization in women diagnosed with endometriosis.

METHODS

A retrospective cohort study of women diagnosed with endometriosis was conducted using Truven MarketScan Commercial database during the study period, January 1, 2011 to December 31, 2016. Women were included if they had one inpatient or two outpatient International Classification of Diseases codes of endometriosis (617.X or N80.X) on 2 separate days, had continuous health plan enrollment for 12 months before (baseline) and after (post-index) the index date (defined as the earliest recorded date of endometriosis diagnosis code) and no diagnoses of cancer (except non-melanoma skin cancer) during the post-index period. Patterns of opioid utilization (e.g., total days’ supply, augmentation), and metrics of prescribing practices (e.g., early refills) in the post-index period were compared between 3 groups of women: users of short-acting opioids only (SAOs), users of long-acting opioids only (LAOs), and users of both LAOs & SAOs utilizing t- and chi-square tests, as appropriate.

RESULTS

The final sample included 58,472 women with endometriosis; 62% filled at least one opioid prescription in the post-index period. Women taking LAOs (27±61 days) or SAOs (23±56 days) only had a significantly lower mean±SD days’ supply compared to the LAO&SAO group (146±41 days; p<0.001). The LAOs&SAOs group had the largest proportion of women augmenting their opioids dose (59%) compared to the LAOs (2%) and SAOs (23%) only groups (p<0.001). Women in the LAOs&SAOs group also had significantly more early opioid refills (26%) compared to the LAOs (0%) and SAOs (1%) only groups (p<0.001).

CONCLUSIONS

Our findings suggest that women with endometriosis who used SAOs and LAOs prescriptions seem to use opioids for a larger number of days, refill opioids prescriptions early, and increase their opioids doses.