*Purpose: Opioid use before and after kidney transplant is strongly associated with morbidity and mortality; yet data assessing opioid utilization has centered on sources with known inaccuracies. The purpose of this study was to evaluate the accuracy of various opioid use data sources compared to state-required opioid prescription data (PDMP, gold-standard), and to determine the impact that the source has on measured outcomes.

*Methods: This was a retrospective, single-center cohort study of opioid use in kidney transplant recipients between 2010-6 assessing associated readmission outcomes. Opioid prescription data was obtained via medication reconciliation, a national pharmaceutical claims database, and the state-mandated PDMP.

*Results: Of 1,116 kidney transplants within the study timeframe, 200 (18%) had PDMP-reported opioid prescriptions filled in the 3 months prior to transplant. Other opioid sources or combinations of opioid sources were able to accurately identify patients that had used opioids 28 to 73% of the time, yet also inaccurately identified 6 to 13% of patients (who did not fill a prescription for opioids during the time period) as opioid users (Table 1). The associations between pre-txp opioid use and readmission rates varied significantly based on the opioid use source (Table 2).

*Conclusions: In order to most optimally mitigate the opioid epidemic, researchers must be able to use the most accurate opioid source data to measure utilization and outcomes and determine risk factors for COU. It is imperative for researchers to have the ability to match state PDMP data with patient-level characteristics to identify opioid users within this population. We strongly urge healthcare workers and researchers to work with state-level politicians to achieve access to this critical information.

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