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. 2022 Apr 1;41(4):484-490.
doi: 10.1097/ICO.0000000000002893.

Opioid Prescribing Patterns for Ulcerative Keratitis

Alexa R Thibodeau  1 , Leslie M Niziol  1 , Bradford L Tannen  1 , Dena Ballouz  1 , Maria A Woodward  1   2
Affiliations

Opioid Prescribing Patterns for Ulcerative Keratitis

Alexa R Thibodeau et al. Cornea. .

Abstract

Purpose: The purpose of this study was to characterize rates of opioid prescription for different ulcerative keratitis types.

Methods: This cohort study included patients diagnosed with ulcerative keratitis according to the University of Michigan electronic health record data between September 1, 2014 and December 22, 2020. Ulcerative keratitis was categorized by etiologic type (bacterial, fungal, viral, acanthamoeba, inflammatory, polymicrobial, or unspecified) using rule-based data classification that accounted for billing diagnosis code, antimicrobial or antiinflammatory medications prescribed, laboratory results, and manual chart review. Opioid prescriptions were converted to morphine milligram equivalent and summed over 90 days from diagnosis. Opioid prescription rate and amount were compared between ulcerative keratitis types.

Results: Of 3322 patients with ulcerative keratitis, 173 (5.2%) were prescribed at least 1 opioid for pain management within 90 days of diagnosis. More patients with acanthamoeba (32.4%), fungal (21.1%), and polymicrobial (25.0%) keratitis were treated with opioids compared with bacterial (6.7%), unspecified (2.9%), or viral (1.8%) keratitis (all Bonferroni adjusted P < 0.05). For the 173 patients who were prescribed opioids, a total of 353 prescriptions were given within 90 days of diagnosis, with half given within the first week after diagnosis. The quantity of opioid prescribed within 90 days from diagnosis was not significantly different between ulcerative keratitis types (P = 0.6559). Morphine milligram equivalent units prescribed ranged from 97.5 for acanthamoeba keratitis to 112.5 for fungal keratitis.

Conclusions: The type of ulcerative keratitis may influence the opioid prescription rate. Providers can better serve patients needing opioids for pain management through improved characterization of pain and development of more tailored pain management regimens.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Histogram displaying the distribution of opioid prescriptions over 90 days from diagnosis
Figure 2.
Figure 2.
Boxplots showing the distribution of opioid quantity prescribed over 90 days from ulcer diagnosis (MME units) in the subset of patients who had at least one opioid prescription (n=173), stratified by ulcerative keratitis type.
See this image and copyright information in PMC

References

    1. Pepose JS, Wilhelmus KR. Divergent approaches to the management of corneal ulcers. Am J Ophthalmol. 1992;114:630–632. - PubMed
    1. Byrd LB, Martin N. Corneal Ulcer. In: StatPearls [Internet]. Stat Pearls Publishing, 2020. - PubMed
    1. Whitcher JP, Srinivasan M, Upadhyay MP. Corneal blindness: a global perspective. Bull World Health Organ. 2001;79:214–221. - PMC - PubMed
    1. Keratitis Sharma S.. Biosci Rep. 2001;21:419–444. - PubMed
    1. Beuerman RW, Tanelian DL. Corneal pain evoked by thermal stimulation. Pain. 1979;7:1–14. - PubMed

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