A nationwide retrospective study of opioid management patterns in 2,468 patients with spinal pain in Korea

Sung Soo Chung, Chun Kun Park, Kyu Jung Cho, Kyoung Hyo Choi, Jin Hyok Kim, Sung Bum Kim, Sung Uk Kuh, Jae Chul Lee, Jae Hyup Lee, Kyu Yeol Lee, Sun Ho Lee, Seong Hwan Moon, Si Young Park, Jae Hang Shim, Byung Chul Son, Myung Ha Yoon, Hye Jeong Park

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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.

Original languageEnglish
Pages (from-to)1122-1131
Number of pages10
JournalAsian Spine Journal
Volume10
Issue number6
DOIs
Publication statusPublished - 2016 Jan 1

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Keywords

  • Chronic pain
  • Opioid
  • Spinal diseases
  • Spine

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Chung, S. S., Park, C. K., Cho, K. J., Choi, K. H., Kim, J. H., Kim, S. B., Kuh, S. U., Lee, J. C., Lee, J. H., Lee, K. Y., Lee, S. H., Moon, S. H., Park, S. Y., Shim, J. H., Son, B. C., Yoon, M. H., & Park, H. J. (2016). A nationwide retrospective study of opioid management patterns in 2,468 patients with spinal pain in Korea. Asian Spine Journal, 10(6), 1122-1131. https://doi.org/10.4184/asj.2016.10.6.1122