Persistent Opioid Use After Hospital Admission From Surgery in New Zealand: A Population-Based Study
Authors' conclusion
Approximately 1 in 11 opioid-naïve patients who were dispensed opioids on surgical discharge, developed POU. Potentially modifiable risk factors for POU, related to how opioids were prescribed included changing opioids after discharge, receiving multiple opioids, and higher total dose of opioids given on discharge.
Study context
- Population
- Opioid-naïve patients undergoing surgery without concomitant trauma and dispensed opioids after discharge from any New Zealand (NZ) hospital, January 2007–December 2019included in the analysis
- Participants
- 260,726 patients
- Outcome
- Incidence of persistent opioid use (POU): opioid use after discharge between 91 and 365 days
- Follow-up
- 91–365 days
Methodological detailsnational (all NZ hospitals), multivariable logistic regression, Population-based study of all NZ hospitals, January 2007 to December 2019, Multivariable logistic regression to identify risk factors for persistent opioid use (POU)
- National (all NZ hospitals)
- Multivariable logistic regression
- Population-based study of all NZ hospitals, January 2007 to December 2019
- Multivariable logistic regression to identify risk factors for POU
Main finding
As reported in the abstract
Incidence of POU
Developed POU: 23,656
9.1%
95% CI 9.0%–9.2%
Observational data: associations, not effects.
Further findings
Risk factors for POU (multivariable logistic regression)
| aOR (95% CI) | ||
|---|---|---|
| Changing to different opioid(s) after discharge | 3.21 (3.04–3.38) | |
| Multiple opioids on discharge | 1.37 (1.29–1.45) | |
| Higher total oral morphine equivalents (>400 mg) | 1.23 (1.23–1.45) | |
| Nonopioid analgesics coprescribed on dischargeLower odds of POU | 0.91 (0.87–0.95) | |
| Neurosurgery | 2.02 (1.83–2.24) | |
| Higher comorbidity burden | 1.90 (1.75–2.07) | |
| Preoperative nonopioid analgesic use | 1.65 (1.60–1.71) | |
| Smoking | 1.44 (1.35–1.54) | |
| Preoperative hypnotics use | 1.35 (1.28–1.42) | |
| 0.20.5125Adjusted odds ratio (log scale) |
- Only small differences between different ethnicities
Original publication
Persistent Opioid Use After Hospital Admission From Surgery in New Zealand: A Population-Based Study. Anesth Analg. Published 4 September 2024. doi:10.
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