OBJECTIVES

: Hemodialysis (HD) patients frequently experience chronic pain and have an elevated risk of opioid-related adverse events. Few studies have examined opioid utilization among these patients. We estimated annual rates of opioid utilization among HD patients.

METHODS

: We used individual-level longitudinal data from the United States Renal Data System and Poisson regression to estimate rates of opioid utilization among HD patients from 2007 through 2014. We limited our analysis to HD patients 18 years and older with consistent Medicare part A, B and D coverage in the Continental United States and Hawaii. Outcome measures included annual rates of opioid (1) prescriptions; (2) pills; (3) days supply; and (4) morphine milligram equivalents (MME) dispensed per 100 person days.

RESULTS

: Of the 485495 patients who met our inclusion criteria, 47% were female and 50% were over 62 years of age. Our preliminary findings suggest, the percentage of HD patients who received at least one opioid prescription remained stable (57-59%) between 2007 and 2013, then declined substantially in 2014 (50%). Overall rates of opioid prescriptions, pills, days supply and MME increased from 2007 to 2010 then declined until 2014. The incidence of opioid prescription among the entire population of HD patients declined from 1.26 per 100 person days in 2009 to 1.00 per 100 person days in 2014. The incidence of opioid pills dispensed peaked in 2011 at 78 pills per 100 person days.

CONCLUSIONS

: Although opioid utilization among HD patients has declined in recent years, HD patients continue to receive a substantial amount of opioids.