Quantity of Opioids Prescribed Linked to Higher Patient-Reported Consumption

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The primary outcome was patient-reported opioid consumption in oral morphine equivalents.
The primary outcome was patient-reported opioid consumption in oral morphine equivalents.

The quantity of postsurgical opioids prescribed may be associated with higher patient-reported opioid consumption, according to a study published in JAMA Surgery.

The study included adults age ≥18 who were prescribed opioid medications after undergoing surgery at 33 health systems in Michigan between January 2017 and September 2017. The primary outcome was patient-reported opioid consumption in oral morphine equivalents. The researchers used linear regression analysis to calculate risk-adjusted opioid consumption with robust standard errors.

A total of 2392 participants (mean age, 55) underwent 1 of 12 surgical procedures examined in the study. The quantity of opioids prescribed was found to be higher than patient-reported opioid consumption (median, 30 pills; interquartile range [IQR], 27 to 45 pills of hydrocodone 5 mg/acetaminophen 325 mg vs 9 pills; IQR, 1 to 25 pills, respectively; P <.001). 

The quantity of opioids prescribed had the strongest association with patient-reported opioid consumption, with 0.53 more pills consumed for every additional pill prescribed (95% CI, 0.40-0.65; P <.001). Another association was established between patient-reported pain in the week after surgery and opioid consumption. Participants who reported moderate and severe vs no pain used a mean of 9±1 and 16±2 more pills, respectively (P <.001). Other risk factors for higher opioid use identified were a history of tobacco use, American Society of Anesthesiologists class, age, procedure type, and inpatient surgery status.

“Recognizing overprescribing and accurately identifying patient consumption after surgery is the first step in improving prescribing practices,” the researchers wrote.

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Reference

Howard R, Fry B, Gunaseelan V, et al. Association of opioid prescribing with opioid consumption after surgery in Michigan. [published online November 7, 2018]. JAMA Surg. doi:10.1001/jamasurg.2018.4234

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