BACKGROUND Patients with cancer-related pain are underrepresented in the opioid literature despite high opioid exposure and numerous risk factors for adverse opioid outcomes, including unnecessary persistent opioid use. The objective of this study was to determine the extent, historical trends, and predictors of new-onset persistent opioid use among older adult women after active breast cancer treatment. METHODS Using Surveillance, Epidemiology, and End Results-Medicare data for opioid-naive women diagnosed with stage 0 to III breast cancer at the age of 66 to 90 years between 2008 and 2013, this study estimated overall and quarterly adjusted probabilities of new-onset persistent opioid use, which was defined as receiving ≥90 days' supply of opioids in the year after active breast cancer treatment. Sensitivity analyses were conducted with an alternative definition of persistent opioid use: any opioid fill 90 to 180 days after active cancer treatment. RESULTS Nearly two-thirds of the subjects received prescription opioid therapy during cancer treatment. Quarterly probabilities of new-onset persistent opioid use after active treatment ranged from 2% to 4%; in sensitivity analyses, the alternative outcome definition resulted in predicted probabilities ranging from 11.4% to 14.7%. Subjects with more advanced disease, a higher comorbidity burden, a low-income status, and greater opioid exposure during active cancer treatment were more likely to develop persistent opioid use. CONCLUSIONS Persistent opioid use was an infrequent occurrence among older adult patients with breast cancer completing cancer treatment between 2008 and 2013. This finding was encouraging because of the concerning opioid trends seen in noncancer populations. However, opportunities to further mitigate unsafe opioid use as a complication of cancer care, including standardization of persistent opioid use definitions, should be explored.

中文翻译：

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老年成年女性在乳腺癌治疗后新出现持续使用阿片类药物的情况。

背景技术尽管阿片类药物的暴露量很高，而且阿片类药物不良反应的危险因素很多，包括不必要的持续使用阿片类药物，但与癌症有关的疼痛的患者在阿片类药物文献中的代表性仍不足。这项研究的目的是确定积极乳腺癌治疗后的成年女性中新发作持续使用阿片类药物的程度，历史趋势和预测因素。方法使用2008年至2013年间66岁至90岁年龄段被确诊为0至III期乳腺癌，年龄为66至90岁的阿片类药物的初诊妇女的监测，流行病学和最终医疗保险数据，该研究估算了总体和季度调整后新发病机率持续使用阿片类药物，定义为在积极的乳腺癌治疗后一年中接受了≥90天的阿片类药物供应。使用持久性阿片类药物的替代定义进行敏感性分析：在积极的癌症治疗后90到180天，任何阿片类药物都会被填充。结果近三分之二的受试者在癌症治疗期间接受了阿片类药物处方治疗。积极治疗后新出现的持续使用阿片类药物的季度概率为2％至4％；在敏感性分析中，替代结果定义导致预测的概率介于11.4％至14.7％之间。在积极的癌症治疗过程中，病情更严重，合并症负担更高，收入水平较低以及阿片类药物暴露量更大的受试者更有可能持续使用阿片类药物。结论在2008年至2013年间完成癌症治疗的老年乳腺癌患者中，持续使用阿片类药物并不常见。这一发现令人鼓舞，因为在非癌症人群中看到了令人担忧的阿片类药物趋势。但是，应该探索进一步减轻不安全的阿片类药物使用作为癌症护理并发症的机会，包括对持久性阿片类药物使用定义进行标准化。