Journal of Pain Research (Apr 2020)

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

  • Veal F,
  • Thompson A,
  • Halliday S,
  • Boyles P,
  • Orlikowski C,
  • Bereznicki L

Journal volume & issue
Vol. Volume 13
pp. 703 – 708

Abstract

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Felicity Veal,1 Angus Thompson,1 Samuel Halliday,2 Peter Boyles,2 Chris Orlikowski,3 Luke Bereznicki1 1Unit for Medication Outcomes Research & Education (UMORE), School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia; 2Department of Health, Hobart, Tasmania, Australia; 3Federal Pain Clinic, Hobart, Tasmania, AustraliaCorrespondence: Felicity VealUnit for Medication Outcomes Research & Education (UMORE), School of Pharmacy and Pharmacology, University of Tasmania, Private Bag 26, Hobart, Tasmania 7001, AustraliaTel +61 36 226 2312Fax +61 36 226 7627Email [email protected]: 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, post-operative, persistence, prescribing

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