Gender differences in use of prescription narcotic medications among living kidney donors. (18th September 2015)

• Record Type: Journal Article
• Authors: Lentine, Krista L.; Lam, Ngan N.; Schnitzler, Mark A.; Garg, Amit X.; Xiao, Huiling; Leander, Sheila E.; Brennan, Daniel C.; Taler, Sandra J.; Axelrod, David; Segev, Dorry L.
• Is Part Of: Clinical transplantation. Volume 29:Number 10(2015)
• Page Start: 927
• Page End: 937
• Publication Date: 2015-09-18
• Subjects: administrative claims data -- health outcomes -- living kidney donors -- narcotic medication -- pharmacy claims; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12599
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Prescription narcotic use among living kidney donors is not well described. Using a unique database that integrates national registry identifiers for living kidney donors (1987–2007) in the United States with billing claims from a private health insurer (2000–2007), we identified pharmacy fills for prescription narcotic medications in periods 1–4 and >4 yr post‐donation and estimated relative likelihoods of post‐donation narcotic use by Cox regression. We also compared narcotic fill rates and medication possession ratios (MPRs, defined as (days of medication supplied)/(days observed)), between donors and age‐ and sex‐matched non‐donors. Overall, rates of narcotic medication fills were 32.3 and 32.4 per 100 person‐years in periods 1–4 and >4 yr post‐donation. After age and race adjustment, women were approximately twice as likely as men to fill a narcotic prescription in years 1–4 (adjusted hazard ratio, aHR, 2.28; 95% confidence interval, CI, 1.86–2.79) and >4 yr (aHR 1.70; 95% CI 1.50–1.93). MPRs in donors were low (<2.5% days exposed), and lower than among age‐ and sex‐matched non‐donors. Prescription narcotic medication use is more common among women than men in the intermediate term after live kidney donation. Overall, total narcotic exposure is low, and lower than among non‐donors from the general population.