Persistent opioid use and opioid-related harm after hospital admissions for surgery and trauma in New Zealand- a population-based retrospective cohort study

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12620000924954

Enrollment

524945

Registered

2020-09-17

Start date

2021-03-17

Completion date

2021-09-01

Last updated

2023-05-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

This study aims to assess how admission to hospitals around New Zealand for surgery or trauma may influence persistent opioid use, and how this may lead to harm (including death) due to adverse effects or from overdose of opioids. We know that rates of opioid use have been on the rise in New Zealand (Health Safety and Quality Commission; HQSC) and elsewhere in the world (e.g. The US, UK and Australia), the HQSC has recently reported that hospital admissions may lead to new opioid use. However, little is known about the contribution that hospital admissions for surgery and trauma may make to persistent opioid use in New Zealand, and its association with serious adverse outcomes. We will use national databases (National Minimum Data Set, NMDS and National Non-admitted Patient Collection) to identify patients who have been admitted for surgery or trauma between 2007 to 2019. Data on the duration and quantity of opioid use (where available) will be obtained for these individuals for a one-year period using the pharmacy dispensing database and linked to events related to harm secondary to opioid use such as mortality, hospitalisation related to opioid toxicity and overdose from national databases. This project will allow us to estimate the risk of prolonged opioid use following hospital admission for surgery or trauma and identify individuals at risk of opioid-related harm. The information will help inform future policy, guidelines and interventions, regarding opioid prescribing after surgery or trauma in New Zealand.

Interventions

Surgical and trauma patients discharged with an opioid prescription from any New Zealand public hospitals between 1st January 2007 and 31st December 2019 will be assessed using the National Minimum Data Set, the National Non-admitted Patient Collection and the NZ Pharmaceutical collection.

Eligibility

Sex/Gender

All

Healthy volunteers

Inclusion criteria

The study population includes all opioid-naïve patients (of any age) who had a surgical procedure and/or were presented to the hospital with trauma in one of NZ’s 39 public hospitals between 1st January 2007 and 31st December 2019.

Exclusion criteria

1) those who have evidence of a surgical procedure and/or traumatic event in 365 days prior to the index date; 2) those who underwent more than one surgical procedure type on the day of surgery; and 3) those with evidence of opioid use disorders (e.g. overdose, misuse or dependence) or opioid prescriptions in 180 days prior to the index date.

Outcome results