Temporal trends in opioid prescribing for common general surgical procedures in the opioid crisis era.
General surgery
Opioid crisis
Opioid prescribing
Postoperative pain
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
17
10
2018
revised:
21
11
2018
accepted:
29
11
2018
pubmed:
18
12
2018
medline:
19
12
2019
entrez:
18
12
2018
Statut:
ppublish
Résumé
Recent data has demonstrated that postoperative patients are at risk of chronic opioid abuse. It is unknown whether surgeon postoperative opioid prescribing changed as the opioid crisis entered its peak. The Institutional Data Warehouse was queried to identify patients who underwent three common elective ambulatory procedures between 2014 and 2018 (n = 3495), including: laparoscopic cholecystectomy, laparoscopic inguinal hernia repair (IHR), and open IHR. The main outcome of interest was opioid pills prescribed, converted to an equianalgesic pill number (1 pill = 5 mg oxycodone). Postoperative opioid prescribing was stable from 2014 to 2016 then decreased significantly in 2017 and 2018 (p < 0.0001). While the median number of pills prescribed remained stable at 30 between 2014 and 2018, the frequency of patients receiving 30 pills decreased significantly. Multivariate analysis demonstrated significantly fewer pills prescribed postoperatively after 2016. Reductions in postoperative pills prescribed over time as the opioid crisis worsened suggests that surgeons may be considering the potential for opioid abuse and diversion. Persistently high median number of pills prescribed and continued variation in number of pills prescribed suggests room for further improvement.
Sections du résumé
BACKGROUND
Recent data has demonstrated that postoperative patients are at risk of chronic opioid abuse. It is unknown whether surgeon postoperative opioid prescribing changed as the opioid crisis entered its peak.
METHODS
The Institutional Data Warehouse was queried to identify patients who underwent three common elective ambulatory procedures between 2014 and 2018 (n = 3495), including: laparoscopic cholecystectomy, laparoscopic inguinal hernia repair (IHR), and open IHR. The main outcome of interest was opioid pills prescribed, converted to an equianalgesic pill number (1 pill = 5 mg oxycodone).
RESULTS
Postoperative opioid prescribing was stable from 2014 to 2016 then decreased significantly in 2017 and 2018 (p < 0.0001). While the median number of pills prescribed remained stable at 30 between 2014 and 2018, the frequency of patients receiving 30 pills decreased significantly. Multivariate analysis demonstrated significantly fewer pills prescribed postoperatively after 2016.
CONCLUSIONS
Reductions in postoperative pills prescribed over time as the opioid crisis worsened suggests that surgeons may be considering the potential for opioid abuse and diversion. Persistently high median number of pills prescribed and continued variation in number of pills prescribed suggests room for further improvement.
Identifiants
pubmed: 30554665
pii: S0002-9610(18)31412-0
doi: 10.1016/j.amjsurg.2018.11.047
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
613-617Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.