|Prescription opioids for back pain and use of medications for erectile dysfunction.|
|PMID: 23459134 Owner: NLM Status: MEDLINE|
|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.
|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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|Type: Journal Article; Research Support, N.I.H., Extramural|
|Title: Spine Volume: 38 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2013 May|
|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|
|Languages: eng Pagination: 909-15 Citation Subset: IM|
|APA/MLA Format Download EndNote Download BibTex|
Analgesics, Opioid / adverse effects, therapeutic use*
Androgens / therapeutic use
Back Pain / drug therapy*, epidemiology
Carbolines / therapeutic use
Depression / epidemiology
Drug Prescriptions / statistics & numerical data
Erectile Dysfunction / chemically induced, drug therapy*, epidemiology
Hormone Replacement Therapy
Imidazoles / therapeutic use
Insurance, Health / organization & administration, statistics & numerical data
Piperazines / therapeutic use
Purines / therapeutic use
Smoking / epidemiology
Sulfones / therapeutic use
Testosterone / therapeutic use*
Triazines / therapeutic use
United States / epidemiology
Urological Agents / therapeutic use
|UL1 TR000128/TR/NCATS NIH HHS|
|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|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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