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Opioid usage differs significantly following ureteroscopy and shockwave lithotripsy, while development of long-term usage is positively correlated with total days’ supply and total MME supplied

  • Urology - Original Paper
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Abstract

Purpose

This study evaluated possible predictors of long-term opioid usage among patients with ureteric stones who received ureteroscopy (URS) or shockwave lithotripsy (SWL). We also assessed opioid usage characteristics of URS and SWL recipients.

Materials and methods

This retrospective study used IQVIA PharMetrics® Plus for Academics administrative claims database from years 2006–2020 to identify patients with a diagnosis of kidney or ureteral stones who were treated with either SWL or URS. We performed unadjusted bivariate analyses to compare opioid use characteristics of URS and SWL recipients, and performed logistic regression to determine demographic and clinical factors associated with becoming a long-term opioid user.

Results

The study population consisted of opioid naive individuals having a diagnosis of a kidney stone who underwent URS (N = 9407) or SWL (N = 4894). About 6.7% (N = 964) of study subjects were long-term opioid users. Unadjusted bivariate associations showed that compared to non-long-term opioid users, long-term opioid users had significantly greater total days’ supply, total morphine milliequivalents (MME) supplied, and claims per month. A similar trend was observed for URS (vs. SWL) recipients. However, compared to SWL recipients, URS recipients had 14.3% (1.2–25.6%; p = 0.034) lower odds of becoming long-term users. Total days’ supply (OR: 1.041 (95% CI 1.030–1.052; p < 0.001) and total MME supplied (OR 1.001 (95% CI 1.000–1.001; p < 0.001) were significantly associated with long-term usage.

Conclusion

Higher total days’ supply and total MME supplied as well as SWL were identified as risk factors for becoming long-term opioid users.

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Abbreviations

SWL:

Shockwave lithotripsy

URS:

Ureteroscopy

MME:

Morphine milliequivalents

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Funding

This study was funded through the Urology Care Foundation Summer Medical Student Fellowship.

Author information

Authors and Affiliations

  1. University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA

    Sammie T. James, Ambrish A. Pandit, Bruno Machado & Nalin Payakachat

  2. Ain Shams University, Cairo, Egypt

    Mohamed Kamel

  3. University of Cincinnati Medical Center, Cincinnati, USA

    Mohamed Kamel

Authors
  1. Sammie T. James
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  2. Ambrish A. Pandit
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  3. Bruno Machado
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  4. Nalin Payakachat
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  5. Mohamed Kamel
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Corresponding author

Correspondence to Sammie T. James.

Ethics declarations

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

This study was deemed to not be human subjects’ research in accordance with our institutions IRB.

Informed consent

The UAMS IRB/Research Privacy Board approved the waiver of HIPAA authorization on 07/23/2020.

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Publisher's Note

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

Special thanks to the Urology Care Foundation as well as the Arkansas Urologic Society for sponsoring this research.

The goal of this project was to examine opioid usage following commonly used procedures to treat kidney and ureteric stones. The hope is that physicians will be able to instead use opioid-free alternatives after these common treatments preventing a multitude of adverse preventable events.

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James, S.T., Pandit, A.A., Machado, B. et al. Opioid usage differs significantly following ureteroscopy and shockwave lithotripsy, while development of long-term usage is positively correlated with total days’ supply and total MME supplied. Int Urol Nephrol 54, 2805–2811 (2022). https://doi.org/10.1007/s11255-022-03313-2

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