Dataset Information

Opioid analgesic use after ambulatory surgery: a descriptive prospective cohort study of factors associated with quantities prescribed and consumed.

ABSTRACT:

Objectives

To prospectively characterise: (1) postoperative opioid analgesic prescribing practices; (2) experience of patients undergoing elective ambulatory surgeries and (3) impact of patient risk for medication misuse on postoperative pain management.

Design

Longitudinal survey of patients 7 days before and 7-14 days after surgery.

Setting

Academic urban safety-net hospital.

Participants

181 participants recruited, 18 surgeons, follow-up data from 149 participants (82% retention); 54% women; mean age: 49 years.

Interventions

None.

Primary and secondary outcome measures

Total morphine equivalent dose (MED) prescribed and consumed, percentage of unused opioids.

Results

Surgeons postoperatively prescribed a mean of 242 total MED per patient, equivalent to 32 oxycodone (5 mg) pills. Participants used a mean of 116 MEDs (48%), equivalent to 18 oxycodone (5 mg) pills (~145 mg of oxycodone remaining per patient). A 10-year increase in patient age was associated with 12 (95% CI (-2.05 to -0.35)) total MED fewer prescribed opioids. Each one-point increase in the preoperative Graded Chronic Pain Scale was associated with an 18 (6.84 to 29.60) total MED increase in opioid consumption, and 5% (-0.09% to -0.005%) fewer unused opioids. Prior opioid prescription was associated with a 55 (5.38 to -104.82) total MED increase in opioid consumption, and 19% (-0.35% to -0.02%) fewer unused opioids. High-risk drug use was associated with 9% (-0.19% to 0.002%) fewer unused opioids. Pain severity in previous 3 months, high-risk alcohol, use and prior opioid prescription were not associated with postoperative prescribing practices.

Conclusions

Participants with a preoperative history of chronic pain, prior opioid prescription, and high-risk drug use were more likely to consume higher amounts of opioid medications postoperatively. Additionally, surgeons did not incorporate key patient-level factors (eg, substance use, preoperative pain) into opioid prescribing practices. Opportunities to improve postoperative opioid prescribing include system changes among surgical specialties, and patient education and monitoring.

SUBMITTER: Shanahan CW

PROVIDER: S-EPMC8362709 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Publications

Opioid analgesic use after ambulatory surgery: a descriptive prospective cohort study of factors associated with quantities prescribed and consumed.

Shanahan Christopher W CW Reding Olivia O Holmdahl Inga I Keosaian Julia J Xuan Ziming Z McAneny David D Larochelle Marc M Liebschutz Jane J

BMJ open 20210812 8

<h4>Objectives</h4>To prospectively characterise: (1) postoperative opioid analgesic prescribing practices; (2) experience of patients undergoing elective ambulatory surgeries and (3) impact of patient risk for medication misuse on postoperative pain management.<h4>Design</h4>Longitudinal survey of patients 7 days before and 7-14 days after surgery.<h4>Setting</h4>Academic urban safety-net hospital.<h4>Participants</h4>181 participants recruited, 18 surgeons, follow-up data from 149 participants ...[more]

PMID: 34385249

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Dataset Information

Opioid analgesic use after ambulatory surgery: a descriptive prospective cohort study of factors associated with quantities prescribed and consumed.

Objectives

Design

Setting

Participants

Interventions

Primary and secondary outcome measures

Results

Conclusions

Publications

Opioid analgesic use after ambulatory surgery: a descriptive prospective cohort study of factors associated with quantities prescribed and consumed.

Similar Datasets

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