Document Detail


Prescription opioids for back pain and use of medications for erectile dysfunction.
MedLine Citation:
PMID:  23459134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Cross-sectional analysis of electronic medical and pharmacy records.
OBJECTIVE: To examine associations between use of medication for erectile dysfunction or testosterone replacement and use of opioid therapy, patient age, depression, and smoking status.
SUMMARY OF BACKGROUND DATA: Males with chronic pain may experience erectile dysfunction related to depression, smoking, age, or opioid-related hypogonadism. The prevalence of this problem in back pain populations and the relative importance of several risk factors are unknown.
METHODS: We examined electronic pharmacy and medical records for males with back pain in a large group model health maintenance organization during 2004. Relevant prescriptions were considered for 6 months before and after the index visit.
RESULTS: There were 11,327 males with a diagnosis of back pain. Males who received medications for erectile dysfunction or testosterone replacement (n = 909) were significantly older than those who did not and had greater comorbidity, depression, smoking, and use of sedative-hypnotics. In logistic regressions, the long-term use of opioids was associated with greater use of medications for erectile dysfunction or testosterone replacement compared with no opioid use (odds ratio, 1.45; 95% confidence interval, 1.12-1.87, P < 0.01). Age, comorbidity, depression, and use of sedative-hypnotics were also independently associated with the use of medications for erectile dysfunction or testosterone replacement. Patients prescribed daily opioid doses of 120 mg of morphine-equivalents or more had greater use of medication for erectile dysfunction or testosterone replacement than patients without opioid use (odds ratio, 1.58; 95% confidence interval, 1.03-2.43), even with adjustment for the duration of opioid therapy.
CONCLUSION: Dose and duration of opioid use, as well as age, comorbidity, depression, and use of sedative-hypnotics, were associated with evidence of erectile dysfunction. These findings may be important in the process of decision making for the long-term use of opioids.
LEVEL OF EVIDENCE: 4.
Authors:
Richard A Deyo; David H M Smith; Eric S Johnson; Carrie J Tillotson; Marilee Donovan; Xiuhai Yang; Amanda Petrik; Benjamin J Morasco; Steven K Dobscha
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Spine     Volume:  38     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-10     Completed Date:  2013-12-09     Revised Date:  2014-05-16    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  909-15     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Analgesics, Opioid / adverse effects,  therapeutic use*
Androgens / therapeutic use
Back Pain / drug therapy*,  epidemiology
Carbolines / therapeutic use
Comorbidity
Cross-Sectional Studies
Depression / epidemiology
Drug Prescriptions / statistics & numerical data
Erectile Dysfunction / chemically induced,  drug therapy*,  epidemiology
Hormone Replacement Therapy
Humans
Imidazoles / therapeutic use
Insurance, Health / organization & administration,  statistics & numerical data
Logistic Models
Male
Middle Aged
Piperazines / therapeutic use
Prevalence
Purines / therapeutic use
Smoking / epidemiology
Sulfones / therapeutic use
Testosterone / therapeutic use*
Triazines / therapeutic use
United States / epidemiology
Urological Agents / therapeutic use
Grant Support
ID/Acronym/Agency:
UL1 TR000128/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Androgens; 0/Carbolines; 0/Imidazoles; 0/Piperazines; 0/Purines; 0/Sulfones; 0/Triazines; 0/Urological Agents; 0/tadalafil; 3M7OB98Y7H/sildenafil; 3XMK78S47O/Testosterone; UCE6F4125H/vardenafil
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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