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Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System

Author

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  • Abass Babatunde

    (Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA
    Center for Public Health Modeling and Response, Clemson University, Clemson, SC 29634, USA)

  • Lior Rennert

    (Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA
    Center for Public Health Modeling and Response, Clemson University, Clemson, SC 29634, USA)

  • Kevin B. Walker

    (Prisma Health, Greenville, SC 29605, USA)

  • Douglas L. Furmanek

    (Prisma Health, Greenville, SC 29605, USA)

  • Dawn W. Blackhurst

    (Prisma Health, Greenville, SC 29605, USA)

  • Vito A. Cancellaro

    (Prisma Health, Greenville, SC 29605, USA)

  • Alain H. Litwin

    (Prisma Health, Greenville, SC 29605, USA
    School of Health Research, Clemson University, Clemson, SC 29634, USA
    School of Medicine Greenville, University of South Carolina, Greenville, SC 29605, USA)

  • Kerry A. Howard

    (Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA
    Center for Public Health Modeling and Response, Clemson University, Clemson, SC 29634, USA)

Abstract

There is growing concern about the over-prescription of opioids and the risks of long-term use. This study examined the relationship between initial need (pre-operative, post-operative, and discharge pain) and dosage of opioids in the first prescription after surgery with continued opioid use through opioid refills over 12 months, while considering patient-level characteristics. A total of 9262 opioid-naïve patients underwent elective surgery, 7219 of whom were prescribed opioids following surgery. The results showed that 17% of patients received at least one opioid refill within one year post-surgery. Higher initial opioid doses, measured in morphine milligram equivalent (MME), were associated with a greater likelihood of continued use. Patients receiving a dose greater than 90 MME were 1.57 times more likely to receive a refill compared to those receiving less than 90 MME (95% confidence interval: 1.30–1.90, p < 0.001). Additionally, patients who experienced pain before or after surgery were more likely to receive opioid refills. Those experiencing moderate or severe pain were 1.66 times more likely to receive a refill (95% confidence interval: 1.45–1.91, p < 0.001). The findings highlight the need to consider surgery-related factors when prescribing opioids and the importance of developing strategies to balance the optimization of pain management with the risk of opioid-related harms.

Suggested Citation

  • Abass Babatunde & Lior Rennert & Kevin B. Walker & Douglas L. Furmanek & Dawn W. Blackhurst & Vito A. Cancellaro & Alain H. Litwin & Kerry A. Howard, 2023. "Association between Initial Opioid Prescription and Patient Pain with Continued Opioid Use among Opioid-Naïve Patients Undergoing Elective Surgery in a Large American Health System," IJERPH, MDPI, vol. 20(10), pages 1-9, May.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:10:p:5766-:d:1143021
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