title: Gender differences in use of prescription narcotic medications among living kidney donors.
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.
authors.affiliation: Center for Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA.|Division of Abdominal Transplantation, Department of Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lentine
authors.affiliation: Division of Nephrology, University of Alberta, Edmonton, AB, Canada.
authors.forename: Ngan N
authors.initials: NN
authors.lastname: Lam
authors.affiliation: Center for Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA.|Division of Abdominal Transplantation, Department of Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schnitzler
authors.affiliation: Division of Nephrology, Western University, London, ON, Canada.
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
authors.affiliation: Center for Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA.
authors.forename: Huiling
authors.initials: H
authors.lastname: Xiao
authors.affiliation: Saint Louis University School of Nursing, St. Louis, MO, USA.
authors.forename: Sheila E
authors.initials: SE
authors.lastname: Leander
authors.affiliation: Transplant Nephrology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Brennan
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Taler
authors.affiliation: Division of Abdominal Transplantation, Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, NH, USA.
authors.forename: David
authors.initials: D
authors.lastname: Axelrod
authors.affiliation: Division of Abdominal Transplantation, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Dorry L
authors.initials: DL
authors.lastname: Segev
mesh_terms: D000328:Adult; D000368:Aged; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009294:Narcotics; D009392:Nephrectomy; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States
chemical_list: D009294:Narcotics
keywords: administrative claims data; health outcomes; living kidney donors; narcotic medication; pharmacy claims