Quantity of Opioids Prescribed Postop Linked to Consumption
Patients use 0.53 more pills for every additional opioid pill prescribed; pain also tied to consumption
(HealthDay News) -- The quantity of opioids prescribed after surgery is associated with patient-reported opioid consumption, according to a study published online in JAMA Surgery.
Ryan Howard, MD, from the University of Michigan in Ann Arbor, and colleagues conducted a retrospective, population-based analysis of opioids prescribed and consumed across 33 health systems in Michigan. A total of 2392 patients who underwent 1 of 12 surgical procedures were included in the analysis.
The researchers found that the quantity of opioids prescribed was significantly higher than the quantity of those consumed (median, 30 pills of hydrocodone/acetaminophen vs 9 pills). The strongest association for patient-reported opioid consumption was seen for the quantity of opioids prescribed; for every additional pill prescribed, patients used 0.53 more pills. There was also a significant, but smaller, correlation between patient-reported pain in the week after surgery and consumption. Patients used a mean of 9 and 16 more pills if they reported moderate and severe pain, respectively, versus no pain. History of tobacco use, American Society of Anesthesiologists class, age, procedure type, and inpatient surgery status were also significant risk factors. Patients in the lowest versus the highest quintile of opioid prescribing had significantly lower mean opioid consumption (5 vs 37 pills) after adjustment for these risk factors.
"Recognizing overprescribing and accurately identifying patient consumption after surgery is the first step in improving prescribing practices," the authors write.
Howard R, Fry B, Gunaseelan V, et al. Association of Opioid Prescribing With Opioid Consumption After Surgery in Michigan. JAMA Surg. DOI:10.1001/jamasurg.2018.4234 (Published online November 7, 2018)