• Family practice · Dec 2024

    The long-term impacts of opioid use before and after joint arthroplasty: matched cohort analysis of New Zealand linked register data.

    • Yana Pryymachenko, Ross Wilson, AbbottJohn HaxbyJH0000-0001-6468-7284Department of Surgical Sciences, Centre for Musculoskeletal Outcomes Research, University of Otago, Dunedin, New Zealand., Michelle Dowsey, and Peter Choong.
    • Department of Surgical Sciences, Centre for Musculoskeletal Outcomes Research, University of Otago, Dunedin, New Zealand.
    • Fam Pract. 2024 Dec 2; 41 (6): 916924916-924.

    BackgroundOpioids are commonly used both before and after total joint arthroplasty (TJA).ObjectiveThe objective of this study was to estimate the long-term effects of pre- and perioperative opioid use in patients undergoing TJA.MethodsWe used linked population datasets to identify all (n =18,666) patients who had a publicly funded TJA in New Zealand between 2011 and 2013. We used propensity score matching to match individuals who used opioids either before surgery, during hospital stay, or immediately post-discharge with individuals who did not based on a comprehensive set of covariates. Regression analysis was used to estimate the effect of opioid use on health and socio-economic outcomes over 5 years.ResultsOpioid use in the 3 months prior to surgery was associated with significant increases in healthcare utilization and costs (number of hospitalizations 6%, days spent in hospital 14.4%, opioid scripts dispensed 181%, and total healthcare costs 11%). Also increased were the rate of receiving social benefits (2 percentage points) and the rates of opioid overdose (0.5 percentage points) and mortality (3 percentage points). Opioid use during hospital stay or post-discharge was associated with increased long-term opioid use, but there was little evidence of other adverse effects.ConclusionsOpioid use before TJA is associated with significant negative health and economic consequences and should be limited. This has implications for opioid prescribing in primary care. There is little evidence that peri- or post-operative opioid use is associated with significant long-term detriments.© The Author(s) 2023. Published by Oxford University Press.

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