Effect of discharge opioid on persistent postoperative opioid use: a retrospective cohort study comparing tapentadol with oxycodone
Authors' conclusion
There appeared to be lower odds of persistence for tapentadol compared with oxycodone among key subgroups, including patients prescribed modified release opioids and those undergoing orthopaedic surgery.
Study context
- Population
- Surgical patients dispensed discharge opioids, 1 January 2016–30 September 2021, grouped by opioid experience (opioid-naive: no opioids in 3 months before discharge) and formulation
- Participants
- 122,836 patients
- Exposure
- Tapentadol vs oxycodone as discharge opioid
- Outcome
- Persistent postoperative opioid use (continued use of any opioid at 90 days after discharge)
- Follow-up
- 90 days after discharge
Methodological detailslinked hospital and community pharmacy data, mixed-effects logistic regression
- Linked hospital and community pharmacy data
- Mixed-effects logistic regression
Main finding
As reported in the abstract
Persistence, by opioid experience and formulation (subgroup)
Tapentadol vs OxycodoneOdds ratio (95% CI)
Modified release, opioid-naive
0.81(0.69–0.94)
Modified release, opioid-experienced
0.81(0.71–0.93)
Observational data: associations, not effects.
Further findings
Persistence rate overall, by opioid experience
- Opioid-naive meeting persistence criteria
- 2.31%
- Opioid-experienced meeting persistence criteria
- 27.24%
Persistence in orthopaedic surgery (subgroup, n = 19,832)
- Odds of persistence significantly lower with tapentadol vs oxycodone regardless of opioid experience or formulation
Original publication
Effect of discharge opioid on persistent postoperative opioid use: a retrospective cohort study comparing tapentadol with oxycodone. Anaesthesia. Published 19 December 2022. doi:10.
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