Out-of-hospital opioid prescriptions after knee and hip arthroplasty: prescribers and the first prescribed opioid
Authors' conclusion
Oxycodone increased as first out-of-hospital prescription between 2013 and 2018. The dose of the first prescribed opioid was associated with the total dose and a small increased risk of prolonged use. First prescriptions were mostly written by orthopaedic surgeons and consecutive prescriptions by general practitioners.
Study context
- Population
- Patients after knee and hip arthroplasty in the Netherlands, 2013–2018 (Dutch Arthroplasty Register linked to pharmacy dispensing data)
- Participants
- 46,106 vs 42,893
- Exposure
- KA vs HA
- KAn = 46,106
- HAn = 42,893
- Outcome
- First prescribed out-of-hospital opioid within 30 days of operation (median MME) and its prescribers
- Follow-up
- Within 30 days of operation
Methodological detailsnational registry linkage
- National registry linkage
Main finding
As reported in the abstract
Opioid prescription (≥1 opioid)
- Oxycodone as first prescribed opioid increased
- from 44% to 85%
- Tramadol as first prescribed opioid decreased
- 64-11%
- Orthopaedic surgeons increasingly prescribed the first prescription, 2013–2018
- 44-69%
- General practitioners mostly prescribed consecutive prescriptions
- >50%
Observational data: associations, not effects.
Further findings
Long-term opioid use (≥1 prescription for >90 postoperative days) per 100 morphine milligram equivalent (MME) increase in first dispensed opioid · first postoperative year
| KA | HA | OR | |
|---|---|---|---|
| KAPer 100 MME increase · logistic regression adjusted for confounders | 1.02 | ||
| Prevalence | 25% | 20% | |
| HAPer 100 MME increase · logistic regression adjusted for confounders | 1.01 |
Total MME per 1% increase in first-prescription MME · first postoperative year
- Increase in total MME (KA/HA, respectively)
- 0.43%/0.37%
- Linear regression adjusted for confounders
Original publication
Out-of-hospital opioid prescriptions after knee and hip arthroplasty: prescribers and the first prescribed opioid. Br J Anaesth. Published 28 February 2023. doi:10.
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