Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain Management
Objective:. Balancing surgical pain management and opioid stewardship is complex. Identifying patient-level variables associated with low or no use can inform tailored prescribing. Methods:. A prospective, observational study investigating surgical procedures, prescription data, and patient-reported...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2023-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000355 |
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| author | Anish K. Agarwal, MD, MPH, MS Ruiying Xiong, MS Jeffrey Ebert, PhD Fran Shofer, PhD Evan Spencer, MS Daniel Lee, MD, MS Zarina Ali, MD, MS M. Kit Delgado, MD, MS |
| author_facet | Anish K. Agarwal, MD, MPH, MS Ruiying Xiong, MS Jeffrey Ebert, PhD Fran Shofer, PhD Evan Spencer, MS Daniel Lee, MD, MS Zarina Ali, MD, MS M. Kit Delgado, MD, MS |
| author_sort | Anish K. Agarwal, MD, MPH, MS |
| collection | DOAJ |
| description | Objective:. Balancing surgical pain management and opioid stewardship is complex. Identifying patient-level variables associated with low or no use can inform tailored prescribing.
Methods:. A prospective, observational study investigating surgical procedures, prescription data, and patient-reported outcomes at an academic health system in Pennsylvania. Surgical patients were consented following surgery, and prospective data were captured using automated text messaging (May 1, 2021–February 29, 2022). The primary outcome was opioid use.
Results:. Three thousand six hundred three (30.2%) patients consented. Variation in patient reported used included 28.1% of men reported zero use versus 24.3% of women, 20.5% of Black patients reported zero use versus 27.2% of white patients. Opioid-naïve patients reported more zero use as compared with chronic use (29.7% vs 9.8%). Patients reporting higher use had more telephone calls and office visits within 30 days but no change in emergency department utilization or admissions. Higher discharge pain score was associated with higher use. In the adjusted analysis of opioid use relative to the guideline, higher use was associated with age, male sex, obesity, discharge pain score, and history of mental health disorder. In the adjusted model, younger age and being opioid naïve were associated with low to zero use across procedures.
Conclusions:. Younger age, being opioid-naïve, and lower discharge pain score are associated with low or no postoperative opioid use. These characteristics can be used by clinicians to help tailor opioid prescribing to specific patients to reduce the risk of prolonged exposure and unused tablets in the community. |
| format | Article |
| id | doaj-art-e1e48dd52d8444558001dd71c7555575 |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-e1e48dd52d8444558001dd71c75555752025-01-24T09:18:12ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932023-12-0144e35510.1097/AS9.0000000000000355202312000-00019Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain ManagementAnish K. Agarwal, MD, MPH, MS0Ruiying Xiong, MS1Jeffrey Ebert, PhD2Fran Shofer, PhD3Evan Spencer, MS4Daniel Lee, MD, MS5Zarina Ali, MD, MS6M. Kit Delgado, MD, MS7From the * Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PAFrom the * Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA† Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PAFrom the * Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PAFrom the * Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA† Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA† Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PAFrom the * Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PAObjective:. Balancing surgical pain management and opioid stewardship is complex. Identifying patient-level variables associated with low or no use can inform tailored prescribing. Methods:. A prospective, observational study investigating surgical procedures, prescription data, and patient-reported outcomes at an academic health system in Pennsylvania. Surgical patients were consented following surgery, and prospective data were captured using automated text messaging (May 1, 2021–February 29, 2022). The primary outcome was opioid use. Results:. Three thousand six hundred three (30.2%) patients consented. Variation in patient reported used included 28.1% of men reported zero use versus 24.3% of women, 20.5% of Black patients reported zero use versus 27.2% of white patients. Opioid-naïve patients reported more zero use as compared with chronic use (29.7% vs 9.8%). Patients reporting higher use had more telephone calls and office visits within 30 days but no change in emergency department utilization or admissions. Higher discharge pain score was associated with higher use. In the adjusted analysis of opioid use relative to the guideline, higher use was associated with age, male sex, obesity, discharge pain score, and history of mental health disorder. In the adjusted model, younger age and being opioid naïve were associated with low to zero use across procedures. Conclusions:. Younger age, being opioid-naïve, and lower discharge pain score are associated with low or no postoperative opioid use. These characteristics can be used by clinicians to help tailor opioid prescribing to specific patients to reduce the risk of prolonged exposure and unused tablets in the community.http://journals.lww.com/10.1097/AS9.0000000000000355 |
| spellingShingle | Anish K. Agarwal, MD, MPH, MS Ruiying Xiong, MS Jeffrey Ebert, PhD Fran Shofer, PhD Evan Spencer, MS Daniel Lee, MD, MS Zarina Ali, MD, MS M. Kit Delgado, MD, MS Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain Management Annals of Surgery Open |
| title | Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain Management |
| title_full | Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain Management |
| title_fullStr | Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain Management |
| title_full_unstemmed | Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain Management |
| title_short | Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain Management |
| title_sort | identifying patient characteristics associated with opioid use to inform surgical pain management |
| url | http://journals.lww.com/10.1097/AS9.0000000000000355 |
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