• Ir J Med Sci · Dec 2023

    Evaluating opioid prescribing patterns following discharge from elective surgical procedures: a worrying trend during the 'opioid crisis' - an audit of elective surgical procedures.

    • Aengus Meldon, Matthew G Davey, and William P Joyce.
    • Department of Surgery, Galway Clinic, Doughiska, Co. Galway , H91 HHT0, Republic of Ireland. meldonaengus@gmail.com.
    • Ir J Med Sci. 2023 Dec 1; 192 (6): 299329992993-2999.

    BackgroundThe 'opioid crisis' has reached epidemic proportions globally. Importantly, 30% of opioid dependency stem from opioids obtained on hospital discharge prescriptions.AimThe aim of this study is to evaluate opioid prescription patterns on discharge of post-operative patients in an Irish Hospital.MethodsA retrospective cohort study was undertaken in a single institution during the 5 year eligibility period (January 2017-October 2021). Comparisons in opioid prescription patterns following minor (inguinal hernia repair (IHR), intermediate (laparoscopic cholecystectomy (LC)) and major (colonic resection (CR)) were made. Descriptive statistics were performed using SPSS version 26.0 RESULTS: In total, 300 patients were included in this study with mean age 59.6 years (range: 20-92). Of these, 112 patients underwent IHR (37.3%), 116 patients underwent LC (38.7%), and 72 patients underwent CR (24.0%). The mean age at diagnosis was 61 years, 53 years and 58 years for IHR, LC and CR, respectively (P < 0.001). Patients undergoing CR were more likely to have greater comorbidity burden (3.1 vs. 1.2 (IHR) vs. 1.8 (LC) respectively (P = 0.030). On discharge, 27.8% of CR patients received opioids (20/72) compared to 24.1% of IHR (28/116) and 15.9% of LC (18/113) patients, respectively (P = 0.126).ConclusionWe observed considerable variability in opioid prescribing patterns following minor, intermediate and major operations in our centre. Care is required when prescribing opioids in the post-operative setting, and opioid prescription guidelines are required to both tackle and prevent an escalation of this 'opioid crisis'.© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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