O128 Time trends in opioid prescribing after discharge following colectomy in england: a cross-sectional study

Abstract

Introduction Opioid prescribing patterns after discharge following colectomy within a population from England are not well characterised. This study aimed to report changes in opioid prescribing prevalence, formulation choices and opioid analgesics over time. Methods This cross-sectional analysis included people undergoing colectomy between 2010 and 2019 using primary (Clinical Practice Research Datalink) and linked secondary care (Hospital Episode Statistics) data. The prevalence of initial opioid prescription within 90 days of surgical discharge was calculated, and prescription characteristics in terms of analgesics and formulation were described. Trend analysis was performed using the Cochran Armitage test, and percentage change between 2010 and 2019 was tested using univariate logistic regression. Results Of the 95,155 individuals undergoing colectomy within the study period, 15,503 (16.3%) received opioid prescriptions. There was a decreasing trend in the prevalence of post-discharge opioids for opioid naïve people (P<0.001), with a decrease from 11.4% in 2010 to 6.7% in 2019 (-41.3%, p<0.001). Whereas the prevalence remained stable for patients prescribed opioids prior to surgery (p=0.637). The prescribing of immediate release formulations decreased from 86% in 2010 to 82% in 2019 (-4.65%). Codeine represented 44.5% of all prescriptions and prescribing increased by 14.5% between 2010 and 2019. Moreover, morphine and oxycodone prescriptions rose significantly by 76.6% and 131%, respectively, while tramadol prescribing dropped by 48%. Conclusion This study identified a changing pattern of opioid prescribing following colectomy, with prescribing prevalence decreasing for opioid naïve people. Trends suggested decreased tramadol prescribing, but a shift toward increasing codeine, oxycodone and morphine prescriptions.

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“…Various examples exist of data sources from other Western countries in which opioid prescription data could be linked to peri-operative prescription of NSAIDs [19,20].…”

“…Reproducibility will also be crucial when using data sources from outside of the USA as (post‐surgery) opioid prescribing patterns differ substantially internationally [18]. Various examples exist of data sources from other Western countries in which opioid prescription data could be linked to peri‐operative prescription of NSAIDs [19, 20].…”