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Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System

There is growing concern about the over-prescription of opioids and the risks of long-term use. This study examined the relationship between initial need (pre-operative, post-operative, and discharge pain) and dosage of opioids in the first prescription after surgery with continued opioid use throug...

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Autores principales: Babatunde, Abass, Rennert, Lior, Walker, Kevin B., Furmanek, Douglas L., Blackhurst, Dawn W., Cancellaro, Vito A., Litwin, Alain H., Howard, Kerry A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218665/
https://www.ncbi.nlm.nih.gov/pubmed/37239497
http://dx.doi.org/10.3390/ijerph20105766
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author Babatunde, Abass
Rennert, Lior
Walker, Kevin B.
Furmanek, Douglas L.
Blackhurst, Dawn W.
Cancellaro, Vito A.
Litwin, Alain H.
Howard, Kerry A.
author_facet Babatunde, Abass
Rennert, Lior
Walker, Kevin B.
Furmanek, Douglas L.
Blackhurst, Dawn W.
Cancellaro, Vito A.
Litwin, Alain H.
Howard, Kerry A.
author_sort Babatunde, Abass
collection PubMed
description There is growing concern about the over-prescription of opioids and the risks of long-term use. This study examined the relationship between initial need (pre-operative, post-operative, and discharge pain) and dosage of opioids in the first prescription after surgery with continued opioid use through opioid refills over 12 months, while considering patient-level characteristics. A total of 9262 opioid-naïve patients underwent elective surgery, 7219 of whom were prescribed opioids following surgery. The results showed that 17% of patients received at least one opioid refill within one year post-surgery. Higher initial opioid doses, measured in morphine milligram equivalent (MME), were associated with a greater likelihood of continued use. Patients receiving a dose greater than 90 MME were 1.57 times more likely to receive a refill compared to those receiving less than 90 MME (95% confidence interval: 1.30–1.90, p < 0.001). Additionally, patients who experienced pain before or after surgery were more likely to receive opioid refills. Those experiencing moderate or severe pain were 1.66 times more likely to receive a refill (95% confidence interval: 1.45–1.91, p < 0.001). The findings highlight the need to consider surgery-related factors when prescribing opioids and the importance of developing strategies to balance the optimization of pain management with the risk of opioid-related harms.
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spelling pubmed-102186652023-05-27 Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System Babatunde, Abass Rennert, Lior Walker, Kevin B. Furmanek, Douglas L. Blackhurst, Dawn W. Cancellaro, Vito A. Litwin, Alain H. Howard, Kerry A. Int J Environ Res Public Health Article There is growing concern about the over-prescription of opioids and the risks of long-term use. This study examined the relationship between initial need (pre-operative, post-operative, and discharge pain) and dosage of opioids in the first prescription after surgery with continued opioid use through opioid refills over 12 months, while considering patient-level characteristics. A total of 9262 opioid-naïve patients underwent elective surgery, 7219 of whom were prescribed opioids following surgery. The results showed that 17% of patients received at least one opioid refill within one year post-surgery. Higher initial opioid doses, measured in morphine milligram equivalent (MME), were associated with a greater likelihood of continued use. Patients receiving a dose greater than 90 MME were 1.57 times more likely to receive a refill compared to those receiving less than 90 MME (95% confidence interval: 1.30–1.90, p < 0.001). Additionally, patients who experienced pain before or after surgery were more likely to receive opioid refills. Those experiencing moderate or severe pain were 1.66 times more likely to receive a refill (95% confidence interval: 1.45–1.91, p < 0.001). The findings highlight the need to consider surgery-related factors when prescribing opioids and the importance of developing strategies to balance the optimization of pain management with the risk of opioid-related harms. MDPI 2023-05-09 /pmc/articles/PMC10218665/ /pubmed/37239497 http://dx.doi.org/10.3390/ijerph20105766 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Babatunde, Abass
Rennert, Lior
Walker, Kevin B.
Furmanek, Douglas L.
Blackhurst, Dawn W.
Cancellaro, Vito A.
Litwin, Alain H.
Howard, Kerry A.
Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System
title Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System
title_full Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System
title_fullStr Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System
title_full_unstemmed Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System
title_short Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System
title_sort association between initial opioid prescription and patient pain with continued opioid use among opioid-naïve patients undergoing elective surgery in a large american health system
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218665/
https://www.ncbi.nlm.nih.gov/pubmed/37239497
http://dx.doi.org/10.3390/ijerph20105766
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