Prescription Size Is A Better Predictor of Opioid Use Than Pain Level

Excessive opioid prescribing is associated with higher patient-reported opioid consumption following surgery, according to the results of a recent study.

Recent evidence has suggested that opioids are overprescribed following surgery, according to the study’s authors. In order to determine factors associated with opioid consumption, they conducted a retrospective, population-based analysis of the quantity of opioids prescribed and patient-reported opioid consumption involving 2392 patients who underwent surgery between January 1, 2017, and September 30, 2017.

Overall, the researchers found that the quantity of opioids prescribed to patients was significantly higher than patient-reported opioid consumption (median 30 pills, interquartile range 27-45 pills of hydrocodone/acetaminophen, 5/325 mg, vs 9 pills; IQR, 1-25 pills), and patients used 0.53 more pills for every additional pill prescribed to them.

While patient-reported pain was also associated with consumption, it was not as strongly associated as was prescription size. Other risk factors included tobacco use, American Society of Anesthesiologists class, age, procedure type, and inpatient surgery status.

After adjusting for these factors, the patients in the lowest quintile of opioid prescribing had significantly lower mean opioid consumption compared with those in the highest quintile.

“The quantity of opioid prescribed is associated with higher patient-reported opioid consumption. Using patient-reported opioid consumption to develop better prescribing practices is an important step in combating the opioid epidemic.”

—Michael Potts

Reference:

Howard R, Fry B, Gunaseelan V, et al. Association of opioid prescribing with opioid consumption after surgery in Michigan [published online November 7, 2018]. JAMA Surg. doi:10.1001/jamasurg.2018.4234