Postdischarge opioid use and persistent use after general surgery: A retrospective study

Area of Science:

• Medical Research
• Public Health
• Pharmacology

Background:

• Opioid overprescribing post-surgery is a major public health concern.
• Limited data exists on postoperative opioid use patterns in New Zealand general surgical patients.
• This study addresses the gap in understanding opioid use after general surgery in New Zealand.

Purpose of the Study:

• To examine opioid use in general surgical patients at Auckland District Health Board.
• To identify factors associated with postoperative opioid use.
• To identify factors associated with persistent opioid use (≥1 prescription 91-180 days post-surgery).

Main Methods:

• Retrospective cohort study design.
• Utilized electronic clinical records and community pharmacy dispensing data.
• Analyzed sociodemographics, surgical characteristics, comorbidities, co-prescribed medications, and opioid use.

Main Results:

• 42.4% of 1,110 patients received opioids post-discharge.
• 9.5% of opioid-naïve patients (n=401) became persistent opioid users.
• Factors associated with opioid use included nonopioid analgesic use, longer hospital stays, higher operation severity, procedure type, and pain scores. Older age was a negative predictor. Persistent use linked to longer stays, high initial opioid load, and female sex; higher surgery severity reduced persistent use risk.

Conclusions:

• A significant proportion of patients develop persistent opioid use after surgery.
• Identified risk factors can inform clinical prescribing to minimize opioid-related adverse events.
• Findings support targeted interventions to manage postoperative opioid use.