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 - Flores, Sonia Lopez
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
PY - 2020/12
Y1 - 2020/12
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.
U2 - 10.1097/SLA.0000000000004225
DO - 10.1097/SLA.0000000000004225
M3 - Journal article
C2 - 32657939
SN - 0003-4932
VL - 272
SP - 879
EP - 886
JO - Annals of Surgery
JF - Annals of Surgery
IS - 6
ER -