Community opioid dispensing after rib fracture injuries: CODI study

Area of Science:

• Pain management
• Pharmacovigilance
• Epidemiology

Background:

• Rib fracture pain frequently necessitates inpatient care and opioid analgesia.
• Understanding post-discharge opioid prescribing patterns for rib fracture patients is limited.
• Long-term opioid use carries known risks, necessitating investigation into prescribing trends.

Purpose of the Study:

• To investigate the duration and dosage of opioid prescriptions following hospital discharge for patients with rib fractures.
• To identify factors associated with prolonged opioid dispensing and increased opioid end-doses in this population.

Main Methods:

• A retrospective cohort study of adult patients hospitalized with rib fractures in Queensland, Australia (2014-2015) was analyzed.
• Data included hospitalizations, mortality, and community opioid dispensing records up to 720 days post-discharge.
• Multivariable logistic regression was used to identify factors associated with long-duration (>90 days) and increased end-dose opioid use.

Main Results:

• Over half (58.8%) of patients received community opioid prescriptions within 30 days of discharge.
• 23.6% experienced long-duration dispensing, and 13.7% had increased opioid end-doses.
• Pre-injury opioid use (OR=12.00), female sex (OR=1.75), and older age (OR=1.86) were significantly associated with prolonged opioid use.

Conclusions:

• Opioid prescribing for rib fractures extends beyond typical recovery periods, particularly in older females.
• Prior opioid use is a strong predictor of long-term and high-dose opioid consumption post-fracture.
• Individualized strategies and a health system approach are needed to mitigate long-term opioid use in at-risk patients.