The prescribed opioid crisis as an impetus to improve postoperative pain management

Simpson, Andrew; Keane, E; Levy, N.

doi:10.1111/anae.16054

Cited by 1 publication

(1 citation statement)

References 25 publications

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“…This recommendation becomes particularly relevant as the current analysis showed that some patients still need opioids within 90 days after discharge, which might raise concerns about the possibility of developing chronic postsurgical pain. As opioids are not recommended for managing chronic postsurgical pain 2 , requests for additional opioids should prompt a comprehensive patient review by the GP or pain specialists for opioid weaning or assessment of chronic postsurgical pain 42 , 43 . Since the data used were collected before the release of these guidelines, future studies should evaluate the impact of guideline implementation on reducing opioid prescribing and opioid-related adverse events for surgical patients.…”

Section: Discussionmentioning

confidence: 99%

Temporal trends and patterns in initial opioid prescriptions after hospital discharge following colectomy in England over 10 years

Baamer,

Humes,

Toh

et al. 2023

BJS Open

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Background While opioid analgesics are often necessary for the management of acute postoperative pain, appropriate prescribing practices are crucial to avoid harm. The aim was to investigate the changes in the proportion of people receiving initial opioid prescriptions after hospital discharge following colectomy, and describe trends and patterns in prescription characteristics. Methods This was a retrospective cohort study. Patients undergoing colectomy in England between 2010 and 2019 were included using electronic health record data from linked primary (Clinical Practice Research Datalink Aurum) and secondary (Hospital Episode Statistics) care. The proportion of patients having an initial opioid prescription issued in primary care within 90 days of hospital discharge was calculated. Prescription characteristics of opioid type and formulation were described. Results Of 95 155 individuals undergoing colectomy, 15 503 (16.3%) received opioid prescriptions. There was a downward trend in the proportion of patients with no prior opioid exposure (opioid naive) who had a postdischarge opioid prescription (P <0.001), from 11.4% in 2010 to 6.7% in 2019 (−41.3%, P <0.001), whereas the proportions remained stable for those prescribed opioids prior to surgery, from 57.5% in 2010 to 58.3% in 2019 (P = 0.637). Codeine represented 44.5% of all prescriptions and prescribing increased by 14.5% between 2010 and 2019. Prescriptions for morphine and oxycodone rose significantly by 76.6% and 31.0% respectively, while tramadol prescribing dropped by 48.0%. The most commonly prescribed opioid formulations were immediate release (83.9%), followed by modified release (5.8%) and transdermal (3.2%). There was a modest decrease in the prescribing of immediate-release formulations from 86.0% in 2010 to 82.0% in 2019 (P <0.001). Conclusion Over the 10 years studied, there was a changing pattern of opioid prescribing following colectomy, with a decrease in the proportion of opioid-naive patients prescribed postdischarge opioids.

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Section: Discussionmentioning

confidence: 99%