TY - JOUR
T1 - Opioids after Surgery in the United States Versus the Rest of the World
T2 - The International Patterns of Opioid Prescribing (iPOP) Multicenter Study
AU - Kaafarani, Haytham M.A.
AU - Han, Kelsey
AU - El Moheb, Mohamad
AU - Kongkaewpaisan, Napaporn
AU - Jia, Zhenyi
AU - El Hechi, Majed W.
AU - Van Wijck, Suzanne
AU - Breen, Kerry
AU - Eid, Ahmed
AU - Rodriguez, Gabriel
AU - Kongwibulwut, Manasnun
AU - Nordestgaard, Ask T.
AU - Sakran, Joseph V.
AU - Ezzeddine, Hiba
AU - Joseph, Bellal
AU - Hamidi, Mohammad
AU - Ortega, Camilo
AU - Lopez Flores, Sonia
AU - Gutierrez-Sougarret, Bernardo J.
AU - Qin, Huanlong
AU - Yang, Jun
AU - Gao, Renyuan
AU - Wang, Zhiguo
AU - Gao, Zhiguang
AU - Prichayudh, Supparerk
AU - Durmaz, Said
AU - Van Der Wilden, Gwendolyn
AU - Santin, Stephanie
AU - Ribeiro, Marcelo A.F.
AU - Noppakunsomboom, Napakadol
AU - Alami, Ramzi
AU - El-Jamal, Lara
AU - Naamani, Dana
AU - Velmahos, George
AU - Lillemoe, Keith D.
N1 - Funding Information:
This study was not funded by third party (government, commercial, private foundation, etc) sources. No external organizations, private or public, had any role in the design, conduct, analysis, or writing up of the study. The corresponding author has full access to study data and had final responsibility for the decision to submit for publication.
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Objective:The International Patterns of Opioid Prescribing study compares postoperative opioid prescribing patterns in the United States (US) versus the rest of the world.Summary of Background Data:The US is in the middle of an unprecedented opioid epidemic. Diversion of unused opioids contributes to the opioid epidemic.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.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).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.
AB - Objective:The International Patterns of Opioid Prescribing study compares postoperative opioid prescribing patterns in the United States (US) versus the rest of the world.Summary of Background Data:The US is in the middle of an unprecedented opioid epidemic. Diversion of unused opioids contributes to the opioid epidemic.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.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).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.
KW - analgesics
KW - narcotics
KW - opioid
KW - postoperative pain
KW - prescription
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U2 - 10.1097/SLA.0000000000004225
DO - 10.1097/SLA.0000000000004225
M3 - Article
C2 - 32657939
AN - SCOPUS:85090787806
SN - 0003-4932
VL - 272
SP - 879
EP - 886
JO - Annals of surgery
JF - Annals of surgery
IS - 6
ER -