More opioids for U.S. surgery patients than for those in other countries
According to a recent study by the International Patterns of Opioid Prescribing Workgroup, patients in the United States are prescribed disproportionally higher amounts of opioids after surgery compared with patients in other countries. The study authors, led by Haytham M.A. Kaafarani, MD, and colleagues at Massachusetts General Hospital, wanted to assess the relationship between perceived pain severity and the amount of opioids prescribed to surgery patients at discharge.
The study, published in the December 1, 2020, issue of the Journal of the American College of Surgeons, involved a post-hoc analysis of the data from the International Patterns of Opioid Prescribing multicenter study.
Adult patients who had undergone appendectomy, cholecystectomy, or inguinal herniorrhaphy between October 2016 and March 2017 in 1 of the 14 participating hospitals across eight countries were included. Pain severity was assessed using a 0 to 10 visual analog scale before hospital discharge, and patients were stratified into no pain, mild pain (1–3), moderate pain (4–6), and severe pain (7–10). The number of opioid prescriptions, total number of pills, and oral morphine equivalents prescribed were calculated for each group.
Among the 2,024 patients in the study, 83% of patients in the United States without pain were prescribed opioids, compared with 8.7% of non-U.S. patients without pain. The number of opioid prescriptions, number of pills, and oral morphine equivalents prescribed were similar across the four pain severity groups for U.S. patients, while the number of opioid prescriptions, number of opioid pills, and oral morphine equivalents prescribed for non-U.S. patients were incrementally higher as the pain severity progressed from no pain to severe pain.
The authors concluded that additional efforts should be directed toward tailoring opioid prescriptions to patients’ needs.