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Study finds patients use few opioids following discharge from elective surgery
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Most patients who underwent elective surgery reported using no or few opioids after they were discharged, according to a presentation at the American Surgical Association Annual Meeting.
Researchers identified 2,550 patients who underwent 25 elective procedures at three academic centers. Of these patients, 1,907 completed a 29-question telephone interview survey between 21 and 35 days after discharge. Opioids following discharge were changed into oral morphine equivalents.
Results showed 92.2% of patients were given opioids at discharge. Investigators noted after discharge, a median of 44 oral morphine equivalents were consumed. On average, investigators found 62.7% of opioids were not used; 31% of patients did not use opioids; and 52.3% of patients needed less than 50 oral morphine equivalents. Refill rates varied from 1.7% for laparoscopic inguinal hernia surgery and 71.4% for lumbar fusion. Out of all patients, 90.2% of patients were satisfied with their pain control post-discharge.
According to researchers, 28.2% of patients who said they were given too many opioids, whereas 8.3% said they were not given enough opioids. There were 7.5% of patients who threw out the remaining opioids. There were 1,428 naïve patients, of which 33.5% did not take opioids and 57.5% took less than 50 oral morphine equivalents. – by Monica Jaramillo
Reference:
Thiels CA, et al. Significant number of patients require no opioids after discharge: Results of a postoperative multicenter initiative aimed at developing opioid prescribing guidelines for 25 elective surgeries. Presented at: American Surgical Association Annual Meeting; April 19-21, 2018; Phoenix.
Disclosure: Mabry reports no relevant financial disclosures.
Perspective
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William T. Obremskey, MD
This study provides further evidence that physicians are part of the problem of diversion of narcotics for illicit use. Only 31% of patients used any of the narcotics and 63% of prescribed narcotics were not used and posed a risk for diversion. The authors are to be applauded for attempting to provide information for physicians on the number of narcotics required after routine elective procedures. In spite of the vast majority of narcotics not being used, 90% of patients were satisfied with their postoperative pain control. This study provides further evidence that physicians can improve postoperative pain medication regimens to decrease the number of narcotics available and maintain high patient satisfaction.
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