Impact of Depression and Anxiety on Opioid Use in Hospitalized Hematopoietic Cell Transplantation Recipients

Madiha Iqbal, Aaron Spaulding, Shehzad Niazi, Chanel Wood, Salman Ahmed, Prachi Jani, Mohamed A. Kharfan-Dabaja, Ernesto Ayala, Rami Manochakian, Steven Ames, Aneel Paulus, Sikander Ailawadhi, Vivek Roy, Asher Chanan-Khan, Taimur Sher

Research output: Contribution to journalArticle

Abstract

Background: Hematopoietic cell recipients are reported to have a high prevalence of depression and anxiety. The impact of depression and anxiety on opioid use has not been well characterized. This is of significance as the opioid epidemic continues, and over 60% of deaths secondary to drug overdose involve the use of opioids. Objective: In this retrospective, single-center study of 275 patients who underwent hematopoietic cell transplantation (HCT) (allogeneic and autologous) for hematological malignancies, we explore the impact of depression and anxiety on opioid use. Results: Patients who were both anxious and depressed at admission for HCT had increased odds of receiving an opioid (odds ratio of 4.50 [95% confidence interval: 1.75, 11.56]) compared with patients who were neither depressed nor anxious. However, patients who were either depressed or anxious did not have different odds of receiving an opioid compared with those who were neither depressed nor anxious. Autologous HCT recipients had reduced odds of receiving an opioid (odds ratio of 0.17 [95% confidence interval: 0.08, 0.38]) compared with patients undergoing allogeneic HCT. Patients with lower Karnofsky performance status (<90 on a scale of 1–100) had an increased incidence of receiving a higher Morphine milligram equivalent daily dosage (incidence rate ratio of 2.59 [95% confidence interval: 1.18, 5.67]) when modeled by zero truncated negative binomial regression. Conclusion: Presence of depression and anxiety impacts opioid use in patients undergoing HCT.

Original languageEnglish (US)
Pages (from-to)363-370
Number of pages8
JournalPsychosomatics
Volume61
Issue number4
DOIs
StatePublished - Jul 1 2020

Keywords

  • anxiety
  • depression
  • hematopoietic cell transplant
  • opioids

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Applied Psychology
  • Psychiatry and Mental health

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