Association of Opioid Type With Opioid Consumption After Surgery.
Journal
Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354
Informations de publication
Date de publication:
01 12 2022
01 12 2022
Historique:
pubmed:
20
2
2021
medline:
11
11
2022
entrez:
19
2
2021
Statut:
ppublish
Résumé
This study was designed to test the hypothesis that patients prescribed hydrocodone consume a similar number of tablets as those prescribed oxycodone after surgery. In October 2017, the Michigan Opioid Prescribing Engagement Network released opioid prescribing guidelines for surgeries. For each procedure, these guidelines recommended prescribing 50% more tablets of hydrocodone than tablets of oxycodone to adjust for potency differences. These guidelines were simplified in January 2019 to recommend the same number of 5 mg hydrocodone tablets as 5 mg oxycodone tablets for each procedure. Retrospective, observational analysis of opioid-naïve adults who underwent surgical procedures across 64 hospitals in Michigan and were prescribed 5 mg tablets of hydrocodone or oxycodone between January 1, 2018 and May 31, 2019. The primary outcome was number of tablets consumed. We defined a meaningful difference in consumption as 5 pills a priori. Secondary outcomes included self-reported pain, satisfaction, and opioid refills. A total of 6842 patients were included. Adjusting for covariates, patients prescribed hydrocodone consumed 7 tablets (95% confidence interval 6.79-7.18) while patients prescribed oxycodone consumed 6 tablets (95% confidence interval 5.58-6.40.) Comparing patients prescribed oxycodone with those prescribed hydrocodone, there were no differences in satisfaction, pain, or refills. Although patients prescribed hydrocodone consumed more tablets than patients prescribed oxycodone, this difference was not clinically significant and did not result in differences in satisfaction, pain, or refills. Perioperative opioid prescribing guidelines may recommend the same number of 5 mg oxycodone and hydrocodone tablets without sacrificing patient-reported outcomes.
Sections du résumé
OBJECTIVE
This study was designed to test the hypothesis that patients prescribed hydrocodone consume a similar number of tablets as those prescribed oxycodone after surgery.
SUMMARY OF BACKGROUND DATA
In October 2017, the Michigan Opioid Prescribing Engagement Network released opioid prescribing guidelines for surgeries. For each procedure, these guidelines recommended prescribing 50% more tablets of hydrocodone than tablets of oxycodone to adjust for potency differences. These guidelines were simplified in January 2019 to recommend the same number of 5 mg hydrocodone tablets as 5 mg oxycodone tablets for each procedure.
METHODS
Retrospective, observational analysis of opioid-naïve adults who underwent surgical procedures across 64 hospitals in Michigan and were prescribed 5 mg tablets of hydrocodone or oxycodone between January 1, 2018 and May 31, 2019. The primary outcome was number of tablets consumed. We defined a meaningful difference in consumption as 5 pills a priori. Secondary outcomes included self-reported pain, satisfaction, and opioid refills.
RESULTS
A total of 6842 patients were included. Adjusting for covariates, patients prescribed hydrocodone consumed 7 tablets (95% confidence interval 6.79-7.18) while patients prescribed oxycodone consumed 6 tablets (95% confidence interval 5.58-6.40.) Comparing patients prescribed oxycodone with those prescribed hydrocodone, there were no differences in satisfaction, pain, or refills.
CONCLUSIONS
Although patients prescribed hydrocodone consumed more tablets than patients prescribed oxycodone, this difference was not clinically significant and did not result in differences in satisfaction, pain, or refills. Perioperative opioid prescribing guidelines may recommend the same number of 5 mg oxycodone and hydrocodone tablets without sacrificing patient-reported outcomes.
Identifiants
pubmed: 33605582
doi: 10.1097/SLA.0000000000004793
pii: 00000658-202212000-00076
doi:
Substances chimiques
Analgesics, Opioid
0
Oxycodone
CD35PMG570
Hydrocodone
6YKS4Y3WQ7
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1070-e1075Subventions
Organisme : NIDA NIH HHS
ID : R01 DA042859
Pays : United States
Organisme : NHLBI NIH HHS
ID : T35 HL007690
Pays : United States
Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Supported by the National Institute on Drug Abuse (NIH R01 DA042859), the NIH (5T35HL007690-35), the Michigan Department of Health and Human Services (MDHHS, E20180672-00 Michigan DHHS - MA-2018 Master Agreement Program), and the Substance Abuse and Mental Health Administration (SAMHSA: E20180568-00 MA-2018 Master Agreement Program). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, MDHHS, or SAMHSA. The authors otherwise have no conflicts of interest to disclose. All authors have read and complied with author guidelines. The authors report no conflicts of interest.
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