Browsing by Author "Bernardo J. Gutierrez-Sougarret"

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • No Thumbnail Available
    PublicationMetadata only
    Opioids After Surgery in the United States Versus the Rest of the World: The International Patterns of Opioid Prescribing (iPOP) Multicenter Study
    (2020-12-01) Haytham M.A. Kaafarani; Kelsey Han; Mohamad El Moheb; Napaporn Kongkaewpaisan; Zhenyi Jia; Majed W. El Hechi; Suzanne van Wijck; Kerry Breen; Ahmed Eid; Gabriel Rodriguez; Manasnun Kongwibulwut; Ask T. Nordestgaard; Joseph V. Sakran; Hiba Ezzeddine; Bellal Joseph; Mohammad Hamidi; Camilo Ortega; Sonia Lopez Flores; Bernardo J. Gutierrez-Sougarret; Huanlong Qin; Jun Yang; Renyuan Gao; Zhiguo Wang; Zhiguang Gao; Supparerk Prichayudh; Said Durmaz; Gwendolyn van der Wilden; Stephanie Santin; Marcelo A.F. Ribeiro; Napakadol Noppakunsomboom; Ramzi Alami; Lara El-Jamal; Dana Naamani; George Velmahos; Keith D. Lillemoe; Shanghai Oriental Hospital; Tongji University; American University of Beirut; Hospital do Servidor Publico Estadual; Massachusetts General Hospital; Chulalongkorn University; Shanghai Jiao Tong University; King Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn University; Leiden University Medical Center - LUMC; Changzheng Hospital; Faculty of Medicine, Siriraj Hospital, Mahidol University; The University of Arizona; Johns Hopkins University; Rede D'Or Hospitals Network; Hospital Departamental de Villavicencio; Hospital Ángeles Pedregal
    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.
  • No Thumbnail Available
    PublicationMetadata only
    Pain or No Pain, We Will Give You Opioids: Relationship Between Number of Opioid Pills Prescribed and Severity of Pain after Operation in US vs Non-US Patients
    (2020-12-01) Mohamad El Moheb; Ava Mokhtari; Kelsey Han; Inge van Erp; Napaporn Kongkaewpaisan; Zhenyi Jia; Gabriel Rodriguez; Manasnun Kongwibulwut; Haytham MA Kaafarani; Joseph V. Sakran; Bellal Joseph; Camilo Ortega; Sonia Lopez Flores; Bernardo J. Gutierrez-Sougarret; Huanlong Qin; Renyuan Gao; Jun Yang; Zhiguo Wang; Zhiguang Gao; Supparerk Prichayudh; Gwendolyn van der Wilden; Napakadol Noppakunsomboom; Ramzi Alami; Shanghai Sixth People's Hospital; Massachusetts General Hospital; Chulalongkorn University; Faculty of Medicine, Siriraj Hospital, Mahidol University
    © 2020 American College of Surgeons Background: Patients in the US receive disproportionally higher amounts of opioids after operations compared with their non-US counterparts. We aimed to assess the relationship between perceived pain severity after operation and the amount of opioid medications prescribed at discharge in US vs non-US patients. Methods: We conducted a post-hoc analysis of the International Patterns of Opioid Prescribing multicenter study. Patients 16 years and older who underwent appendectomy, cholecystectomy, or inguinal herniorrhaphy in 1 of 14 participating hospitals across 8 countries between October 2016 and March 2017 were included. In hospitals where pain severity was assessed using a 0 to 10 visual analog scale before hospital discharge, patients were stratified into the following groups, depending on the pain severity: none, mild (1 to 3), moderate (4 to 6), and severe (7 to 10). The number of opioid prescriptions, total number of pills, and oral morphine equivalents prescribed were calculated for each group and US and non-US patients were compared. Results: A total of 2,024 patients were included. Eighty-three percent of US patients without pain were prescribed opioids compared with 8.7% of non-US patients without pain (p < 0.001). The number of opioid prescriptions, number of pills, and oral morphine equivalents prescribed were similar across the 4 pain severity groups in US patients (p > 0.05). In contrast, the number of opioid prescriptions, number of opioid pills, and oral morphine equivalents prescribed among non-US patients were incrementally higher as the pain severity progressed from no pain to severe pain (all, p < 0.05). Conclusions: US patients are prescribed opioids at high rates and doses regardless of pain severity. Additional efforts should be directed toward tailoring opioid prescriptions to patients’ needs.