Purpose: To characterize rates of opioid prescription for different ulcerative keratitis types. Methods: This cohort study included patients diagnosed with ulcerative keratitis according to 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 anti-inflammatory medications prescribed, laboratory results and manual chart review. Opioid prescriptions were converted to milligram morphine equivalents (MME) and summed over 90 days from diagnosis. Opioid prescription rate and amount were compared between ulcerative keratitis types. Results: Of 3,322 patients with ulcerative keratitis, 173 (5.2%) were prescribed at least one 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 to bacterial (6.7%), unspecified (2.9%) or viral (1.8%) keratitis (all Bonferroni adjusted p<0.05). For the 173 patients that 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). MME units prescribed ranged from 97.5 for acanthamoeba keratitis to 112.5 for fungal keratitis. Conclusion: Type of ulcerative keratitis may influence 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.
【저자키워드】 opioid, prescribing, Ulcerative keratitis,