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. 2020 Apr 5:13:703-708.
doi: 10.2147/JPR.S235764. eCollection 2020.

The Persistence of Opioid Use Following Surgical Admission: An Australian Single-Site Retrospective Cohort Study

Felicity Veal  1 , Angus Thompson  1 , Samuel Halliday  2 , Peter Boyles  2 , Chris Orlikowski  3 , Luke Bereznicki  1
Affiliations

The Persistence of Opioid Use Following Surgical Admission: An Australian Single-Site Retrospective Cohort Study

Felicity Veal et al. J Pain Res. .

Abstract

Background: Acute pain is common following surgery, with opioids frequently employed in its management. Studies indicate that commencing an opioid during a hospital admission increases the likelihood of long-term use. This study aimed to identify the prevalence of opioid persistence amongst opioid-naïve patients following surgery as well as the indication for use.

Methods: A retrospective review of patients who underwent a surgical procedure at the Royal Hobart Hospital, Tasmania, Australia, between August and September 2016 was undertaken. Patients were linked to the Tasmanian real-time prescription monitoring database to ascertain if they were subsequently dispensed a Schedule 8 opioid (morphine, codeine oxycodone, buprenorphine, hydromorphone, fentanyl, methadone, or tapentadol) and the indication for use.

Results: Of the 3275 hospital admissions, 1015 opioid-naïve patients were eligible for inclusion. Schedule 8 opioids were dispensed at or within 2 days of discharge in 41.7% of admissions. Thirty-nine (3.9%) patients received prescribed opioids 2-months post-discharge; 1.8% of the patients were approved by State Health to be prescribed Schedule 8 opioids regularly for a chronic condition at 6 months, and 1.3% received infrequent or one-off prescriptions for Schedule 8 opioids at 6 months. Thirteen (1.3%) patients continued Schedule 8 opioids for at least 6 months following their surgery, with the indication for treatment either related to the surgery or the condition which surgery was sought for.

Conclusion: This study found that there was a low rate of Schedule 8 opioid persistence following surgery, indicating post-surgical pain is not a significant driver for persistent opioid use.

Keywords: opioids; persistence; post-operative; prescribing.

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Conflict of interest statement

Professor Bereznicki reports personal fees from Boehringer Ingelheim Pty Ltd, grants from Aspen Pharmacare Australia, outside the submitted work. Dr Chris Orlikowski has received funding from Seqirus for speaking at educational meetings, outside of the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Use of opioids by post-surgical patients.
See this image and copyright information in PMC

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