Postoperative opioids administered to inpatients with major or orthopaedic surgery: A retrospective cohort study using data from hospital electronic prescribing systems
Yun-Ting Huang, William G. Dixon, Terence W. O’Neill, Meghna Jani
Abstract
Opioids administered in hospital during the immediate postoperative period are likely to influence post-surgical outcomes, but inpatient prescribing during the admission is challenging to access. Modified-release (MR) preparations have been especially associated with harm,
Introduction
Opioids are an important treatment option in the management of postoperative pain. Poorly controlled postoperative pain may result in increased morbidity, poor quality of life and impaired functional recovery [1]. Research shows up to 10% of opioid-naïve patients who take opioids in the postoperative period transition to persistent opioid use [1].
Materials and Methods
This retrospective cohort study included patients who were admitted to a teaching hospital in the North West of England between 1/1/2010 and 31/08/2021 due to major or orthopaedic surgery. Major surgery included surgery to the organs of the head, chest and abdomen, such as removal of a brain tumour, open-heart surgery, organ transplant or appendicectomy.
Result
Among patients admitted to the hospital for major or orthopaedic procedures, 71.1% of the patients (i.e., 57.0% of the admissions) had opioids administered during their hospitalisation.
Discussion
This study, to our knowledge, is the first UK study to assess opioid utilisation patterns in the immediate postoperative period using inpatient administered drug data. Amongst patients who underwent major or orthopaedic surgery, 71.1% of patients were administered opioids during their hospitalization.
Conclusion
In 2021, 1 in 10 patients on MR opioids and 1 in 6 patients ≤70 years were administered initial oxycodone IR following major or orthopaedic surgery.
Citation: Huang Y-T, Dixon WG, O’Neill TW, Jani M (2024) Postoperative opioids administered to inpatients with major or orthopaedic surgery: A retrospective cohort study using data from hospital electronic prescribing systems. PLoS ONE 19(6): e0305531. https://doi.org/10.1371/journal.pone.0305531
Editor: Stefano Turi, IRCCS: IRCCS Ospedale San Raffaele, ITALY
Received: February 2, 2024; Accepted: June 2, 2024; Published: June 25, 2024
Copyright: © 2024 Huang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: “This study uses patient-level pseudonymised data from the Northern Care Alliance that is not publicly available. The data contains potentially sensitive data that required both Health Research Authority approval and University Research Ethics approval for this study. The data for the study were accessed and analysed within a Secure Research Environment that is hosted by Northern Care Alliance. In order to access the data, researchers will need to be Office of National Statistics Safe Researcher accredited (https://www.ons.gov.uk/aboutus/whatwedo/statistics/requestingstatistics/secureresearchservice/becomeanaccreditedresearcher) and need to have undergone appropriate background checks prior to permission being granted from the host organisation. We confirm the authors did not have any specific privileges to access the third party data and other researchers can access the data in the same manner. Requests for data access can be sent to the Northern Care Alliance team (https://www.northerncarealliance.nhs.uk/contact-us)."
Funding: This work was funded by a Versus Arthritis grant (grant ID: 22481) and a NIHR grant (NIHR301413). MJ is funded through an NIHR Advanced Fellowship (NIHR301413). The funder of this study had no role in study design, data collection, data analysis, data interpretation, writing of this article, or the decision to submit the article for publication. The work was also supported by the Centre for Epidemiology Versus Arthritis (grant ID: 21755).
Competing interests: WGD has received consultancy fees from Google unrelated to this work. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0305531#abstract0
