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Opioids After Surgery in the United States Versus the Rest of the World: The International Patterns of Opioid Prescribing (iPOP) Multicenter Study.
- Source :
-
Annals of surgery [Ann Surg] 2020 Dec; Vol. 272 (6), pp. 879-886. - Publication Year :
- 2020
-
Abstract
- Objective: The International Patterns of Opioid Prescribing study compares postoperative opioid prescribing patterns in the United States (US) versus the rest of the world.<br />Summary of Background Data: The US is in the middle of an unprecedented opioid epidemic. Diversion of unused opioids contributes to the opioid epidemic.<br />Methods: Patients ≥16 years old undergoing appendectomy, cholecystectomy, or inguinal hernia repair in 14 hospitals from 8 countries during a 6-month period were included. Medical records were systematically reviewed to identify: (1) preoperative, intraoperative, and postoperative characteristics, (2) opioid intake within 3 months preoperatively, (3) opioid prescription upon discharge, and (4) opioid refills within 3 months postoperatively. The median/range and mean/standard deviation of number of pills and OME were compared between the US and non-US patients.<br />Results: A total of 4690 patients were included. The mean age was 49 years, 47% were female, and 4% had opioid use history. Ninety-one percent of US patients were prescribed opioids, compared to 5% of non-US patients (P < 0.001). The median number of opioid pills and OME prescribed were 20 (0-135) and 150 (0-1680) mg for US versus 0 (0-50) and 0 (0-600) mg for non-US patients, respectively (both P < 0.001). The mean number of opioid pills and OME prescribed were 23.1 ± 13.9 in US and 183.5 ± 133.7 mg versus 0.8 ± 3.9 and 4.6 ± 27.7 mg in non-US patients, respectively (both P < 0.001). Opioid refill rates were 4.7% for US and 1.0% non-US patients (P < 0.001).<br />Conclusions: US physicians prescribe alarmingly high amounts of opioid medications postoperatively. Further efforts should focus on limiting opioid prescribing and emphasize non-opioid alternatives in the US.
Details
- Language :
- English
- ISSN :
- 1528-1140
- Volume :
- 272
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Annals of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 32657939
- Full Text :
- https://doi.org/10.1097/SLA.0000000000004225