Publication: 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
Issued Date
2020-12-01
Resource Type
ISSN
18791190
10727515
10727515
Other identifier(s)
2-s2.0-85092541416
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the American College of Surgeons. Vol.231, No.6 (2020), 639-648
Suggested Citation
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 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. Journal of the American College of Surgeons. Vol.231, No.6 (2020), 639-648. doi:10.1016/j.jamcollsurg.2020.08.771 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/60539
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Title
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
Author(s)
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
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
Abstract
© 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.