{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:24:00Z","timestamp":1791257040529,"version":"4.1.0"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1OT2OD032581"],"award-info":[{"award-number":["1OT2OD032581"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prescription opioids are essential in managing pain among adults with chronic pain conditions. However, persistent use over time can lead to negative health consequences. Identifying individuals with persistent use over time and their characteristics can inform clinical decision-making and aid in reducing the risk of abuse and overdose deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to examine trajectories of prescription opioid use over time and factors associated with these trajectories among older cancer survivors with any non-cancer pain conditions (NCPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study design with longitudinal data of older (age at cancer diagnosis \u226567\u00a0years) cancer (incident breast, colorectal, and prostate cancers, or non-Hodgkin lymphoma) survivors with any NCPC. Data were derived from the 2007-2015 linked Surveillance, Epidemiology, and End Results (SEER)-Medicare dataset (N = 35,071). Group-Based Trajectory Modeling (GBTM) was used to identify homogeneous subgroups (distinct trajectories) of individuals based on every 90-day prescription opioid use during pre-cancer diagnosis (t\n                      <jats:sub>1<\/jats:sub>\n                      -t\n                      <jats:sub>4<\/jats:sub>\n                      ), acute cancer treatment (t\n                      <jats:sub>5<\/jats:sub>\n                      -t\n                      <jats:sub>8<\/jats:sub>\n                      ), and post-cancer treatment (t\n                      <jats:sub>9<\/jats:sub>\n                      -t\n                      <jats:sub>12<\/jats:sub>\n                      ) periods. Biological factors, social determinants of health (SDoH), physical and mental health, medication use, health care use, and external factors associated with a trajectory membership were analyzed with multivariable multinomial logistic regressions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four distinct trajectories of opioid use were identified: (1) increase-decrease use (6.1%); (2) short-term use after cancer diagnosis (40.6%); (3) low-use (41.0%); and (4) persistent use (12.3%). In the fully-adjusted multinomial logistic regression, the SDoH such as Non-Hispanic Black [adjusted odds ratios (AOR) = 1.69; 95%CI = 1.48, 1.93)] and rural residence (AOR = 1.49; 95%CI = 1.15, 1.94)], comorbid anxiety (AOR = 1.33; 95%CI = 1.18, 1.51), and medication use (NSAIDs - AOR = 1.20; 95%CI = 1.10, 1.30) were associated with membership in the persistent use group. Persistent use was less likely among those with higher fragmented care index (AOR = 0.95, 95%CI = 0.93, 0.97) and those living in counties with higher Medicare advantage penetration (AOR = 0.96; 95%CI = 0.95, 0.97).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>One in eight older adults had persistent opioid use over time. The profile characteristics of this group were different from the other trajectory groups. Policies and programs to reduce chronic opioid use need to consider the intra- and inter-individual variability to reduce opioid-related morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748241290769","type":"journal-article","created":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T10:38:56Z","timestamp":1729334336000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Prescription Opioid Use before and after Diagnosis of Cancer Among Older Cancer Survivors With Non-Cancer Chronic Pain Conditions (NCPCs): An Application of Group-Based Trajectory Modeling (GBTM)"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4906-9212","authenticated-orcid":false,"given":"Rudi","family":"Safarudin","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Tadulako University, Palu, Central Sulawesi, Indonesia"},{"name":"Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA"},{"name":"Prescription Drug Misuse Education and Research (PREMIER) Center, College of Pharmacy, University of Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6998-2650","authenticated-orcid":false,"given":"Traci","family":"LeMasters","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA"},{"name":"OPEN Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5983-8965","authenticated-orcid":false,"given":"Salman","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8311-1360","authenticated-orcid":false,"given":"Usha","family":"Sambamoorthi","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA"},{"name":"Department of Pharmacotherapy, College of Pharmacy, University of North Texas Health Sciences Center, Fort Worth, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,19]]},"reference":[{"key":"bibr1-10732748241290769","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30430-1"},{"key":"bibr2-10732748241290769","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2011\/14\/145"},{"key":"bibr3-10732748241290769","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny247"},{"key":"bibr4-10732748241290769","doi-asserted-by":"publisher","DOI":"10.1080\/15360288.2020.1734710"},{"key":"bibr5-10732748241290769","doi-asserted-by":"publisher","DOI":"10.1097\/NHH.0000000000000743"},{"key":"bibr6-10732748241290769","doi-asserted-by":"publisher","DOI":"10.1080\/03009742.2016.1218543"},{"key":"bibr7-10732748241290769","doi-asserted-by":"publisher","DOI":"10.3389\/FNAGI.2016.00144"},{"key":"bibr8-10732748241290769","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2021.24.31-40"},{"key":"bibr9-10732748241290769","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2011.04.002"},{"key":"bibr10-10732748241290769","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000963"},{"key":"bibr11-10732748241290769","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6501e1externalicon"},{"key":"bibr12-10732748241290769","doi-asserted-by":"publisher","DOI":"10.15585\/MMWR.RR7103A1"},{"key":"bibr13-10732748241290769","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PMED.1003947"},{"key":"bibr14-10732748241290769","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANETWORKOPEN.2022.34671"},{"key":"bibr15-10732748241290769","volume-title":"Brief Description of SEER-Medicare Database","author":"Institute NC","year":"2019"},{"key":"bibr16-10732748241290769","unstructured":"US-DHHR. 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