Abstracts

Rationale: Rationale: Analgesic opioid use has increased dramatically in the general population in recent years. Prescription opioids have been associated with abuse, addiction, misuse, overdose, and other adverse social and health consequences with resultant increased health care costs. Although opioid analgesics are not indicated for the treatment of epilepsy, we wished to determine whether comorbid disorders or epilepsy-associated injuries result in increased opioid use in an insured epilepsy population. Methods: Methods: We compared the incidence of analgesic opioid use in an epilepsy patient population with the incidence in a matched nonepilepsy control population using health insurance claims and membership data from nine United States health plans for the year 2012. Individuals with epilepsy (n=10,271) were match-paired at a 1:2 ratio to individuals without epilepsy (n=20,542) within each health plan using propensity scores derived using gender, age group, and insurance type. Matched comparison groups had 53% females and 47% males with an average age of 34 years for the epilepsy group and 33 years for controls. Each matched comparison group included 66% with commercial insurance, 30% with Medicaid insurance, and 4% with Medicare coverage. Results: Results: Based on prescriptions that were filled at least once during 2012, analgesic opioids were used by 26% of individuals in the epilepsy group vs. 18% of controls (p<0.001) (Figure 1). Compared with matched controls, the epilepsy group had a significantly higher percentage of individuals with all pain conditions examined: joint pain or stiffness (16% vs. 11%), abdominal pain (14% vs. 9%), headache (14% vs. 5%), pain in limb (12% vs. 7%), chest pain (11% vs. 6%), sprain of different parts (9% vs. 7%), sinusitis (9% vs. 7%), migraine (8% vs. 2%), lumbago (8% vs. 6%), backache (6% vs. 4%), cervicalgia (6% vs. 3%), fracture (5% vs. 3%), fibromyalgia (4% vs. 3%), chronic pain (3% vs. 1%), sciatica (1.4% vs. 1%), and jaw pain (0.4% vs. 0.1%) (all p<0.001) (Figure 2). Conclusions: Conclusions: Individuals with epilepsy were significantly more likely to use opioid analgesics in 2012 than matched controls. All pain conditions examined were significantly more prevalent in the epilepsy group than in matched controls.