2085P - Buprenorphine use and cancer outcomes

Background

Pain symptoms are common among individuals with cancer, often necessitating pain management as part of cancer care. Opioids are thus mainstay in cancer care, notwithstanding the risk of adverse psychosocial sequelae associated with opioid use, including opioid use disorder (OUD). Buprenorphine is commonly used in managing OUD; however, it is unclear whether there are differences in the characteristics of individuals with cancer receiving buprenorphine, and what perioperative outcomes are associated with buprenorphine use.

Methods

We used data from Premier Health Database, a comprehensive electronic healthcare database with over 1,000 contributing healthcare systems and > 10 million inpatient admissions annually. We built a cohort of 616 patients undergoing surgical care for cancer between 2008 and 2020 who received buprenorphine as part of their care, and matched to 6,160 other patients with cancer randomly selected in the database who also underwent surgical care without receiving buprenorphine. We characterized demographic and clinical factors associated with receipt of buprenorphine, and also examined the association between receiving buprenorphine and perioperative outcomes, including length of stay (LOS, in days), hospitalization cost (in US dollars/$), and in-hospital mortality.

Results

Older individuals were less likely to receive buprenorphine (aOR = 0.95; 95% CI 0.94, 0.97), while patients with Medicaid insurance (aOR = 1.76; 95% CI 1.02, 3.03) and Medicare (aOR = 1.49; 95% CI 1.00, 2.24) were more likely to receive buprenorphine, compared to those with private insurance. We also found a significant association between radiation treatment and receipt of buprenorphine (aOR = 2.18; 95% CI 1.31, 3.61). In examining perioperative outcomes associated with receipt of buprenorphine, we found that while receipt of buprenorphine was not associated with in-hospital mortality, it was associated with decreased odds of being discharged home after care (aOR = 0.43; 95% CI 0.30, 0.63), increased hospital LOS (estimate = 3.50; 95% CI 2.79, 4.21), and increased overall cost of care (estimate = $10,353; 95% CI $7,846.54, $12,859.00).

Conclusions

Receipt of buprenorphine is also associated with odds of increased hospital LOS and increased cost of care.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.