Skip to main content

Advertisement

SpringerLink
Log in

Long-term opioid use among patients with chronic gout: a cross-sectional study of a sample cohort in South Korea

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Objectives

This study aimed to determine trends in the prevalence of chronic opioid users among patients with chronic gout in South Korea from 2002 to 2015 and to investigate the factors associated with chronic opioid use among patients with chronic gout.

Methods

We performed a population-based cohort study and extracted data from the National Health Insurance Service database in South Korea. We included all adult patients (age ≥ 18 years) with a diagnostic code of M1A* (chronic gout) according to the International Classification of Disease (10th revision).

Results

The prevalence of chronic opioid users among patients with chronic gout has gradually increased from 4.0% in 2002 to 19.4% in 2015. After excluding the patients who had a history of cancer or other rheumatic diseases, a total of 18,042 patients with chronic gout were included in this cross-sectional cohort study in 2015, of which 993 (5.5%) were long-term opioid users. In a multivariable model, older age, female sex, Charlson Comorbidity Index > 2, long-term use of other analgesics, such as pregabalin, gabapentin, paracetamol, and glucocorticoids, and the use of other gout medication (colchicine) were independently associated with higher rates of long-term opioid use among patients with chronic gout.

Conclusion

Chronic opioid users among patients with chronic gout increased from 2002 to 2015 in South Korea. Female sex, older age, comorbid status, and the use of other non-opioid analgesics were independently associated with higher rates of long-term opioid use among patients with chronic gout.

Key Points

• Chronic opioid users among patients with chronic gout have increased from 2002 to 2015 in South Korea.

• Among patients with chronic gout, 5.5% were long-term opioid users.

• Female sex, older age, comorbid status, and the use of other non-opioid analgesics were associated with higher rates of long-term opioid use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Ragab G, Elshahaly M, Bardin T (2017) Gout: an old disease in new perspective - a review. J Adv Res 8(5):495–511. https://doi.org/10.1016/j.jare.2017.04.008

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  2. Kim KY, Ralph Schumacher H, Hunsche E, Wertheimer AI, Kong SX (2003) A literature review of the epidemiology and treatment of acute gout. Clin Ther 25(6):1593–1617. https://doi.org/10.1016/s0149-2918(03)80158-3

    Article  PubMed  Google Scholar 

  3. Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F, National Arthritis Data W (2008) Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 58(1):26–35. https://doi.org/10.1002/art.23176

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kuo CF, Grainge MJ, Zhang W, Doherty M (2015) Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol 11(11):649–662. https://doi.org/10.1038/nrrheum.2015.91

    Article  PubMed  Google Scholar 

  5. Richette P, Bardin T (2010) Gout. Lancet 375(9711):318–328. https://doi.org/10.1016/S0140-6736(09)60883-7

    Article  PubMed  CAS  Google Scholar 

  6. Xia Y, Wu Q, Wang H, Zhang S, Jiang Y, Gong T, Xu X, Chang Q, Niu K, Zhao Y (2019) Global, regional and national burden of gout, 1990-2017: a systematic analysis of the Global Burden of Disease Study. Rheumatology (Oxford). https://doi.org/10.1093/rheumatology/kez476

  7. Singh JA, Cleveland JD (2019) Gout and chronic pain in older adults: a Medicare claims study. Clin Rheumatol 38(7):1953–1960. https://doi.org/10.1007/s10067-019-04526-0

    Article  PubMed  Google Scholar 

  8. Shekelle PG, Newberry SJ, FitzGerald JD, Motala A, O'Hanlon CE, Tariq A, Okunogbe A, Han D, Shanman R (2017) Management of Gout: a systematic review in support of an American College of Physicians Clinical Practice Guideline. Ann Intern Med 166(1):37–51. https://doi.org/10.7326/M16-0461

    Article  PubMed  Google Scholar 

  9. Dalal DS, Mbuyi N, Shah I, Reinert S, Hilliard R, Reginato A (2019) Prescription opioid use among acute gout patients discharged from the emergency department. Arthritis Care Res (Hoboken). https://doi.org/10.1002/acr.23928

  10. Ray WA, Chung CP, Murray KT, Hall K, Stein CM (2016) Prescription of long-acting opioids and mortality in patients with chronic noncancer pain. JAMA 315(22):2415–2423. https://doi.org/10.1001/jama.2016.7789

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M, Initiative S (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS Med 4(10):e297. https://doi.org/10.1371/journal.pmed.0040297

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lee J, Lee JS, Park SH, Shin SA, Kim K (2017) Cohort profile: the National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea. Int J Epidemiol 46(2):e15. https://doi.org/10.1093/ije/dyv319

    Article  PubMed  Google Scholar 

  13. Jiang X, Orton M, Feng R, Hossain E, Malhotra NR, Zager EL, Liu R (2017) Chronic opioid usage in surgical patients in a large academic center. Ann Surg 265(4):722–727. https://doi.org/10.1097/SLA.0000000000001780

    Article  PubMed  PubMed Central  Google Scholar 

  14. Pereira J, Lawlor P, Vigano A, Dorgan M, Bruera E (2001) Equianalgesic dose ratios for opioids. A critical review and proposals for long-term dosing. J Pain Symptom Manag 22(2):672–687

    Article  CAS  Google Scholar 

  15. De Meulemeester M, Mateus E, Wieberneit-Tolman H, Betteridge N, Ireland L, Petersen G, Maske NJ, Jansen TL, Perez-Ruiz F (2020) Understanding the patient voice in gout: a quantitative study conducted in Europe. BJGP Open. https://doi.org/10.3399/bjgpopen20X101003

  16. Brook RA, Forsythe A, Smeeding JE, Lawrence Edwards N (2010) Chronic gout: epidemiology, disease progression, treatment and disease burden. Curr Med Res Opin 26(12):2813–2821. https://doi.org/10.1185/03007995.2010.533647

    Article  PubMed  Google Scholar 

  17. Oh TK, Jeon YT, Choi JW (2019) Trends in chronic opioid use and association with five-year survival in South Korea: a population-based cohort study. Br J Anaesth 123(5):655–663. https://doi.org/10.1016/j.bja.2019.08.012

    Article  PubMed  CAS  Google Scholar 

  18. Oh TK, Song IA, Lee JH, Lim C, Jeon YT, Bae HJ, Jo YH, Jee HJ (2019) Preadmission chronic opioid usage and its association with 90-day mortality in critically ill patients: a retrospective cohort study. Br J Anaesth 122(6):e189–e197. https://doi.org/10.1016/j.bja.2019.03.032

    Article  PubMed  Google Scholar 

  19. Fam AG (1998) Gout in the elderly. Clinical presentation and treatment. Drugs Aging 13(3):229–243. https://doi.org/10.2165/00002512-199813030-00006

    Article  PubMed  CAS  Google Scholar 

  20. Bolzetta F, Veronese N, Manzato E, Sergi G (2013) Chronic gout in the elderly. Aging Clin Exp Res 25(2):129–137

    Article  Google Scholar 

  21. De Souza A, Fernandes V, Ferrari AJ (2005) Female gout: clinical and laboratory features. J Rheumatol 32(11):2186–2188

    PubMed  Google Scholar 

  22. Park YB, Park YS, Song J, Lee WK, Suh CH, Lee SK (2000) Clinical manifestations of Korean female gouty patients. Clin Rheumatol 19(2):142–146. https://doi.org/10.1007/s100670050033

    Article  PubMed  CAS  Google Scholar 

  23. Khanna PP, Gladue HS, Singh MK, FitzGerald JD, Bae S, Prakash S, Kaldas M, Gogia M, Berrocal V, Townsend W Treatment of acute gout: a systematic review. In: Seminars in arthritis and rheumatism, 2014. vol 1. Elsevier, pp 31–38

  24. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G (2004) Alcohol intake and risk of incident gout in men: a prospective study. Lancet 363(9417):1277–1281. https://doi.org/10.1016/S0140-6736(04)16000-5

    Article  PubMed  Google Scholar 

  25. Neogi T, Jansen TL, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, Brown M, Choi H, Edwards NL, Janssens HJ, Liote F, Naden RP, Nuki G, Ogdie A, Perez-Ruiz F, Saag K, Singh JA, Sundy JS, Tausche AK, Vaquez-Mellado J, Yarows SA, Taylor WJ (2015) 2015 gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 74(10):1789–1798. https://doi.org/10.1136/annrheumdis-2015-208237

    Article  PubMed  PubMed Central  CAS  Google Scholar 

Download references

Code availability

Not applicable.

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam, 463-707, South Korea

    Tak Kyu Oh & In-Ae Song

Authors
  1. Tak Kyu Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. In-Ae Song
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

TKO and IAS contributed to the study design and methodology, analyzed the data, and drafted the first manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to In-Ae Song.

Ethics declarations

Disclosures

None.

Ethics approval and consent to participate

The study protocol was approved by the Institutional Review Board of Seoul National University Bundang Hospital (no. X-1905-541-902) and the Health Insurance Review and Assessment Service (NHIS-2019-2-160).

Consent for publication

Not applicable.

Consent to participate

Informed consent was waived because data analyses were performed retrospectively with anonymous data derived from the South Korean National Health Insurance Service (NHIS) database.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix. ICD-10 codes

Appendix. ICD-10 codes

The ICD-10 codes used by comorbidity to compute the Charlson comorbidity index are as follows:

○ Myocardial infarction: I21.x, I22.x, I25.2

○ Congestive heart failure: I09.9, I11.0, I13.0, I13.2, I25.5, I42.0, I42.5–I42.9, I43.x, I50.x, P29.0

○ Peripheral vascular disease: I70.x, I71.x, I73.1, I73.8, I73.9, I77.1, I79.0, I79.2, K55.1, K55.8, K55.9, Z95.8, Z95.9

○ Cerebrovascular disease: G45.x, G46.x, H34.0, I60.x–I69.x

○ Dementia: F00.x–F03.x, F05.1, G30.x, G31.1

○ Chronic pulmonary disease: I27.8, I27.9, J40.x–J47.x, J60.x–J67.x, J68.4, J70.1, J70.3

○ Rheumatic disease: M05.x, M06.x, M31.5, M32.x–M34.x, M35.1, M35.3, M36.0

○ Peptic ulcer disease: K25.x–K28.x

○ Mild liver disease: B18.x, K70.0–K70.3, K70.9, K71.3–K71.5, K71.7, K73.x, K74.x, K76.0, K76.2–K76.4, K76.8, K76.9, Z94.4

○ Diabetes without chronic complication: E10.0, E10.1, E10.6, E10.8, E10.9, E11.0, E11.1, E11.6, E11.8, E11.9, E12.0, E12.1, E12.6, E12.8, E12.9, E13.0, E13.1, E13.6, E13.8, E13.9, E14.0, E14.1, E14.6, E14.8, E14.9

○ Diabetes with chronic complication: E10.2–E10.5, E10.7, E11.2–E11.5, E11.7, E12.2–E12.5, E12.7, E13.2–E13.5, E13.7, E14.2–E14.5, E14.7

○ Hemiplegia or paraplegia: G04.1, G11.4, G80.1, G80.2, G81.x, G82.x, G83.0–G83.4, G83.9

○ Renal disease: I12.0, I13.1, N03.2–N03.7, N05.2–N05.7, N18.x, N19.x, N25.0, Z49.0–Z49.2, Z94.0, Z99.2

○ Any malignancy, including lymphoma and leukemia, except malignant neoplasm of skin: C00.x–C26.x, C30.x–C34.x, C37.x–C41.x, C43.x, C45.x–C58.x, C60.x–C76.x, C81.x–C85.x, C88.x, C90.x–C97.x

○ Moderate or severe liver disease: I85.0, I85.9, I86.4, I98.2, K70.4, K71.1, K72.1, K72.9, K76.5, K76.6, K76.7

○ Metastatic solid tumor: C77.x–C80.x

○ AIDS/HIV: B20.x–B22.x, B24.x

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oh, T.K., Song, IA. Long-term opioid use among patients with chronic gout: a cross-sectional study of a sample cohort in South Korea. Clin Rheumatol 39, 3033–3039 (2020). https://doi.org/10.1007/s10067-020-05085-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-020-05085-5

Keywords

Search

Navigation