BACKGROUND: This study evaluated the risk of long-term analgesic use after low-risk surgery in older adults not previously prescribed analgesics. METHODS: We conducted a retrospective cohort study using linked, population-based administrative data in Ontario, Canada, from April 1, 1997, through December 31, 2008. We identified Ontario residents 66 years and older who were dispensed an opioid within 7 days of a short-stay surgery (cataract surgery, laparoscopic cholecystectomy, transurethral resection of the prostate, or varicose vein stripping) and assessed the risk of long-term opioid use, defined as a prescription for an opioid within 60 days of the 1-year anniversary of the surgery. In a secondary analysis, we examined the risk of long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). We used multivariate logistic regression to examine the association between postsurgical use of analgesics and long-term use. RESULTS: Among 391,139 opioid-naive patients undergoing short-stay surgery, opioids were newly prescribed to 27,636 patients (7.1%) within 7 days of being discharged from the hospital, and opioids were prescribed to 30,145 patients (7.7%) at 1 year from surgery. An increase in the use of oxycodone was found during this time (from 5.4% within 7 days to 15.9% at 1 year). In our primary analysis, patients receiving an opioid prescription within 7 days of surgery were 44% more likely to become long-term opioid users within 1 year compared with those who received no such prescription (adjusted odds ratio, 1.44; 95% CI, 1.39-1.50). In a secondary analysis, among 383,780 NSAID-naive patients undergoing short-stay surgery, NSAIDs were prescribed to 1169 patients (0.3%) within 7 days of discharge and to 30,080 patients (7.8%) at 1 year from surgery. Patients who began taking NSAIDs within 7 days of surgery were almost 4 times more likely to become long-term NSAID users compared with patients with no such prescription (adjusted odds ratio, 3.74; 95% CI, 3.27-4.28). CONCLUSION: Prescription of analgesics immediately after ambulatory surgery occurs frequently in older adults and is associated with long-term use.
BACKGROUND: This study evaluated the risk of long-term analgesic use after low-risk surgery in older adults not previously prescribed analgesics. METHODS: We conducted a retrospective cohort study using linked, population-based administrative data in Ontario, Canada, from April 1, 1997, through December 31, 2008. We identified Ontario residents 66 years and older who were dispensed an opioid within 7 days of a short-stay surgery (cataract surgery, laparoscopic cholecystectomy, transurethral resection of the prostate, or varicose vein stripping) and assessed the risk of long-term opioid use, defined as a prescription for an opioid within 60 days of the 1-year anniversary of the surgery. In a secondary analysis, we examined the risk of long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). We used multivariate logistic regression to examine the association between postsurgical use of analgesics and long-term use. RESULTS: Among 391,139 opioid-naive patients undergoing short-stay surgery, opioids were newly prescribed to 27,636 patients (7.1%) within 7 days of being discharged from the hospital, and opioids were prescribed to 30,145 patients (7.7%) at 1 year from surgery. An increase in the use of oxycodone was found during this time (from 5.4% within 7 days to 15.9% at 1 year). In our primary analysis, patients receiving an opioid prescription within 7 days of surgery were 44% more likely to become long-term opioid users within 1 year compared with those who received no such prescription (adjusted odds ratio, 1.44; 95% CI, 1.39-1.50). In a secondary analysis, among 383,780 NSAID-naive patients undergoing short-stay surgery, NSAIDs were prescribed to 1169 patients (0.3%) within 7 days of discharge and to 30,080 patients (7.8%) at 1 year from surgery. Patients who began taking NSAIDs within 7 days of surgery were almost 4 times more likely to become long-term NSAID users compared with patients with no such prescription (adjusted odds ratio, 3.74; 95% CI, 3.27-4.28). CONCLUSION: Prescription of analgesics immediately after ambulatory surgery occurs frequently in older adults and is associated with long-term use.
Authors: Daniel Cunningham; Brian Lewis; Carolyn Hutyra; Shane Nho; Steven Olson; Richard Mather Journal: Arthroscopy Date: 2018-02-02 Impact factor: 4.772
Authors: Chad M Brummett; Jackie Evans-Shields; Christina England; Amanda M Kong; Carolyn R Lew; Caroline Henriques; Nicole M Zimmerman; Eric C Sun Journal: J Manag Care Spec Pharm Date: 2021-02-24
Authors: Naheed K Jivraj; Faizal Raghavji; Jennifer Bethell; Duminda N Wijeysundera; Karim S Ladha; Brian T Bateman; Mark D Neuman; Hannah Wunsch Journal: Anesthesiology Date: 2020-06 Impact factor: 7.892
Authors: Margaret E Smith; Jay S Lee; Aaron Bonham; Oliver A Varban; Jonathan F Finks; Arthur M Carlin; Amir A Ghaferi Journal: Surg Endosc Date: 2018-10-23 Impact factor: 4.584