MP40-11 TRENDS IN OPIOID AND NONSTEROIDAL ANTI-INFLAMMATORY DRUG USE FOR PATIENTS WITH KIDNEY STONES IN UNITED STATES EMERGENCY DEPARTMENTS FROM 2015 TO 2021

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You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation I (MP40)1 May 2024MP40-11 TRENDS IN OPIOID AND NONSTEROIDAL ANTI-INFLAMMATORY DRUG USE FOR PATIENTS WITH KIDNEY STONES IN UNITED STATES EMERGENCY DEPARTMENTS FROM 2015 TO 2021 Richard B. Berman, Juliana Villanueva, Ezra J. Margolin, Adithya Balasubramanian, Justin Lee, and Ojas Shah Richard B. BermanRichard B. Berman , Juliana VillanuevaJuliana Villanueva , Ezra J. MargolinEzra J. Margolin , Adithya BalasubramanianAdithya Balasubramanian , Justin LeeJustin Lee , and Ojas ShahOjas Shah View All Author Informationhttps://doi.org/10.1097/01.JU.0001008788.18007.3f.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal colic is frequently treated with opioids; however, narcotic analgesic use can lead to dependence and abuse. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also effective in managing renal colic with a different risk profile. We evaluated trends in opioid and NSAID use for pain management of kidney stones in United States emergency departments from 2015 to 2021. METHODS: Kidney stone encounters were identified using National Hospital Ambulatory Medical Care Survey data. We applied a multistage survey weighting procedure to account for selection probability, nonresponse, and population weights. Medication use trends were estimated via logistic regressions on the timing of the encounter, adjusted for selected demographic and clinical characteristics. Results were considered statistically significant with two-sided p-values < 0.01. RESULTS: Between 2015 and 2021, there were an estimated 9,433,291 kidney stone encounters in United States emergency departments. The mean age was 47 (± 17) years, 55% of patients were male, and 74% were White. Overall, 6,425,403 (68%) patients received opioids and 6,067,957 (64%) patients received NSAIDs. Opioid use decreased significantly (annual odds ratio [OR]: 0.87, p=0.003), and there was no significant trend in NSAID use. At discharge, male patients were more likely than females (OR: 1.93, p=0.001) to receive opioids, and Black patients were less likely than White patients (OR: 0.34, p=0.010) to receive opioids. Regional variation was also observed, with higher odds of discharge prescriptions in the West (OR: 3.15, p=0.003) and Midwest (OR: 2.49, p=0.010), compared to the Northeast. 35% of patients received opioids that were stronger than morphine, including oxycodone (19%), hydromorphone (19%), and fentanyl (4.7%). CONCLUSIONS: These results suggest improved opioid stewardship from emergency department physicians in response to the national opioid epidemic. However, regional variation as well as disparities in discharge prescriptions for Black and female patients underscore opportunities for continued efforts. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e668 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Richard B. Berman More articles by this author Juliana Villanueva More articles by this author Ezra J. Margolin More articles by this author Adithya Balasubramanian More articles by this author Justin Lee More articles by this author Ojas Shah More articles by this author Expand All Advertisement PDF downloadLoading ...

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