Publication: Opioids After Surgery in the United States Versus the Rest of the World: The International Patterns of Opioid Prescribing (iPOP) Multicenter Study
Issued Date
2020-12-01
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ISSN
15281140
Other identifier(s)
2-s2.0-85090787806
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Annals of surgery. Vol.272, No.6 (2020), 879-886
Suggested Citation
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 Opioids After Surgery in the United States Versus the Rest of the World: The International Patterns of Opioid Prescribing (iPOP) Multicenter Study. Annals of surgery. Vol.272, No.6 (2020), 879-886. doi:10.1097/SLA.0000000000004225 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/60546
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Title
Opioids After Surgery in the United States Versus the Rest of the World: The International Patterns of Opioid Prescribing (iPOP) Multicenter Study
Author(s)
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
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
Other Contributor(s)
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
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
Abstract
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.