The use of opioid-free analgesia to manage postsurgical pain is still limited, particularly in some patient groups that may be at a higher risk for opioid-related adverse drug events, according to a study published in Current Medical Research and Opinion.
The researchers analyzed data regarding hospital and patient characteristics associated with opioid-free analgesia from the Cerner Health Facts database, spanning from January 2011 to December 2015. They used descriptive statistics and logistic regression to identify predictors of opioid-free analgesia for patients and hospitals.
Overall, 10,219 patients from 187 hospitals who received postsurgical opioid-free analgesia and 255,196 patients who received postsurgical opioids were identified. The rates of opioid-free analgesia varied by hospital.
The results indicated that patients were more likely to receive opioid-free analgesia if they were older (odds ratio [OR], 1.06; 95% CI, 1.03-1.10; P <.001), had neurological disorders (OR, 1.24; 95% CI, 1.10-1.39; P <.001), had diabetes (OR, 1.20; 95% CI, 1.08-1.33; P =.001), or had psychosis (OR, 1.18; 95% CI, 1.01-1.37; P =.030).
In this cohort, patients with depression or obesity were found to be less likely to receive opioid-free analgesia (OR, 0.80 [95% CI, 0.67-0.95; P =.010] and OR, 0.85 [95% CI, 0.73-0.98; P =.030], respectively).
“[A] substantial proportion of [opioid-free analgesia] patients was contributed by a few hospitals with especially high rates of [opioid-free analgesia], suggesting that hospital policies, institutional structure, and cross-functional departmental commitment to reducing opioid use may play a large role in the implementation of [opioid-free analgesia],” concluded the study authors.
This study was supported by Mallinckrodt Pharmaceuticals. The study sponsor was involved in the development of the study design, interpretation and analysis of data, writing the manuscript, and submission for publication.
Urman RD, Böing EA, Khangulov V, et al. Analysis of predictors of opioid-free analgesia for management of acute post-surgical pain in the United States [published online May 25, 2018]. Curr Med Res Opin. doi: 10.1080/03007995.2018.1481376