Amount of opioids prescribed after hospital discharge varies
Eric Y. Chen, M.D., Ph.D., from Boston Medical Center, and colleagues conducted a retrospective record review of 18,343 postoperative patients who were discharged home after a postoperative inpatient admission of at least 24 hours.
The researchers found that given a postoperative patient's 24-hour predischarge opioid use, there was wide variation in the amount of opioids prescribed at hospital discharge. Overall, 35.7 percent of patients used no opioids in the 24 hours before discharge; 45.6 percent of these patients were prescribed opioids at hospital discharge. The services with the highest rates of potential over-prescription tended to have the highest rates of patients still using opioids at hospital discharge (obstetrics [adjusted odds ratio, 3.146; 95 percent confidence interval, 2.094 to 4.765], gynecology [adjusted odds ratio, 2.355; 95 percent confidence interval, 1.663 to 3.390], orthopedics [adjusted odds ratio, 0.943; 95 percent confidence interval, 0.719 to 1.242], and plastic surgery [adjusted odds ratio, 0.733; 95 percent confidence interval, 0.334 to 1.682]). The only service that did not have any cases of potential over-prescription was pediatric surgery.
"Opioids are not regularly prescribed in a patient-specific manner to postoperative patients," the authors write. "Potential opioid over-prescription occurs regularly after surgery among almost all surgical specialties."
One author disclosed financial ties to Smith & Nephew and Exploramed.
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