Abstract
Objective
To characterize opioid fills after surgical abortion among US commercially-insured
women.
Study design
We identified women aged 15–50 years with an outpatient claim for dilation and curettage
or evacuation surgical abortion (D&C/D&E) in IBM MarketScan 2015–2018 and excluded
patients with > 1 opioid fill in the prior 90 days, evidence of opioid dependence
or abuse in the prior 180 days (baseline), miscarriage in 7 days prior, or mifepristone
use in 3 to 7 days prior. We describe the frequency of an oral opioid fill within
7 days after abortion, refill within 42 days of initial fill, and chronic use (≥ 6
fills) in 1 year after abortion. We used multivariable logistic regression to evaluate
predictors of opioid fill including patient and procedure characteristics.
Results
Among 28,252 patients who underwent induced surgical abortion, 2,340 (8.3%) filled
an opioid prescription within 7 days. The strongest predictors of opioid fill were
non-Northeast region, use of moderate sedation for the procedure, and baseline depression.
Among 2,250 patients with an initial fill and sufficient follow-up, 10.0% had a refill
within 42 days of initial fill. Among 15,353 patients with sufficient follow-up, patients
with an opioid fill after abortion had a higher percentage of subsequent chronic use
than those without (2.1% and 0.4%, respectively).
Conclusion
The frequency of an opioid fill after surgical abortion among commercially-insured
women was notable given it is not recommended for post-procedural analgesia. Opioid
prescribing contrary to recommendations may be associated with subsequent chronic
use or abuse.
Implications statement
Despite public health efforts to decrease opioid prescribing, these findings suggest
opioid prescribing after surgical abortion as a potential source of overprescribing
among commercially insured patients in the United States. As surgical abortion is
a minimally-invasive procedure, prescribing opioids for use in this setting may contribute
to chronic use.
Keywords
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Article info
Publication history
Published online: July 27, 2021
Accepted:
July 14,
2021
Received in revised form:
July 12,
2021
Received:
January 17,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
