TY - JOUR
T1 - What Explains Poor Health-related Quality of Life Associated with Opioid Use among Adults with Chronic Noncancer Pain Conditions? A Blinder-Oaxaca Decomposition
AU - Patel, Jayeshkumar
AU - Alhussain, Khalid
AU - Sambamoorthi, Usha
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/3
Y1 - 2021/3
N2 - Objectives:The objective of this study was to estimate the extent to which differences in person-level characteristics between opioid users and nonusers contribute to poor health-related quality of life (HRQoL) of long-term opioid users with chronic noncancer pain condition (CNCP).Materials and Methods:We conducted a retrospective cohort study of adults (n=5917) using longitudinal data from multiple years of Medical Expenditure Panel Survey. Adults with CNCP were classified into short-term, long-term, and opioid nonusers. We measured HRQoL with physical component summary (PCS) and mental component summary (MCS) scores from the Short-Form 12 Questionnaire. A regression decomposition analysis of results from linear regression was performed.Results:Among adults with CNCP, 17.8% and 17.2% reported long-term and short-term opioid use, respectively. Long-term opioid users had lower PCS scores (β=-4.48; P<0.001) as compared with nonusers, even after adjusting for other independent variables. There were no statistically significant associations of long-term opioid use to MCS and short-term opioid use to both PCS and MCS scores. Postlinear regression decomposition analyses revealed that 44.8% of the difference in PCS scores (-3.76 of -8.41) was explained by differences in employment, physical activity, number of CNCP, and other chronic conditions, and use of nonopioid pain medications between long-term opioid users and nonusers.Conclusions:Long-term opioid use was associated with lower HRQoL. The difference in HRQoL between long-term opioid users and nonusers was explained by both modifiable and nonmodifiable patient characteristics. Our findings suggest that improving HRQoL among long-term opioid users may require interventions and policies both within and beyond health care.
AB - Objectives:The objective of this study was to estimate the extent to which differences in person-level characteristics between opioid users and nonusers contribute to poor health-related quality of life (HRQoL) of long-term opioid users with chronic noncancer pain condition (CNCP).Materials and Methods:We conducted a retrospective cohort study of adults (n=5917) using longitudinal data from multiple years of Medical Expenditure Panel Survey. Adults with CNCP were classified into short-term, long-term, and opioid nonusers. We measured HRQoL with physical component summary (PCS) and mental component summary (MCS) scores from the Short-Form 12 Questionnaire. A regression decomposition analysis of results from linear regression was performed.Results:Among adults with CNCP, 17.8% and 17.2% reported long-term and short-term opioid use, respectively. Long-term opioid users had lower PCS scores (β=-4.48; P<0.001) as compared with nonusers, even after adjusting for other independent variables. There were no statistically significant associations of long-term opioid use to MCS and short-term opioid use to both PCS and MCS scores. Postlinear regression decomposition analyses revealed that 44.8% of the difference in PCS scores (-3.76 of -8.41) was explained by differences in employment, physical activity, number of CNCP, and other chronic conditions, and use of nonopioid pain medications between long-term opioid users and nonusers.Conclusions:Long-term opioid use was associated with lower HRQoL. The difference in HRQoL between long-term opioid users and nonusers was explained by both modifiable and nonmodifiable patient characteristics. Our findings suggest that improving HRQoL among long-term opioid users may require interventions and policies both within and beyond health care.
KW - chronic noncancer pain
KW - decomposition analysis
KW - health-related quality of life
KW - opioid analgesics
UR - http://www.scopus.com/inward/record.url?scp=85101746102&partnerID=8YFLogxK
U2 - 10.1097/ADT.0000000000000201
DO - 10.1097/ADT.0000000000000201
M3 - Article
AN - SCOPUS:85101746102
SN - 1531-5754
VL - 20
SP - 10
EP - 20
JO - Addictive Disorders and their Treatment
JF - Addictive Disorders and their Treatment
IS - 1
ER -