Factors Contributing to Opioid Overprescribing at Surgical Discharge

Area of Science:

• Pain Management
• Pharmacology
• Health Services Research

Background:

• Opioids are standard for acute pain but often overprescribed post-operatively.
• Clinical guidance for postoperative opioid prescribing is limited.
• This study investigates surgery duration as a risk factor for overprescribing.

Purpose of the Study:

• To determine if surgery length is an independent risk factor for opioid overprescribing at discharge.
• To identify patient-specific factors associated with opioid overprescribing.

Main Methods:

• Retrospective case-control study at an academic medical center.
• Analyzed 4367 patients meeting eligibility criteria.
• Used logistic regression to assess the association between surgery length and overprescribing.

Main Results:

• Overprescribing at discharge occurred in 30.84% of patients.
• Increased surgery length was independently associated with higher risk of overprescribing (AOR 1.150).
• Older age, male sex, non-White race, and lower pain scores were also risk factors.

Conclusions:

• Overprescribing at discharge contributes to excess opioids in the community, risking abuse and diversion.
• Opioid prescribing decisions are influenced by factors beyond inpatient use.
• Utilizing patient-specific data, like 24-hour morphine equivalent daily dose before discharge, can guide prescribing.