None listed
Conditions
Brief summary
Pain relief is considered a fundamental right in medicine. With over 80% of patients reporting pain after surgical procedures, adequate postoperative analgesia is essential to patient care. However, pain management is complex and requires the consideration of many factors including the specific surgical procedure, patients’ needs, and their perceived analgesic control. Opioid prescriptions for non-cancer-related indications, including postoperative reasons, have been increasing in recent years. While often effective for acute pain, opioids are addictive and have numerous side effects, the most serious being respiratory depression. In the United States, there are 530 opioid-related deaths every week and the opioid epidemic has been recognized as a public health emergency. The many nonfatal health consequences of opioid abuse and addiction in Australia contribute to an annual cost of $15.7 billion. In Australia, opioid-related deaths in adults between 15-64 years of age have increased by 3.8% per year since 2007. In New Zealand, the figures are similar, with the rate of opioid-related deaths increasing by one-third in total from 2001 to 2012. Globally, the overprescription of opioids after common surgical procedures is a well-recognized contributor to the opioid epidemic, including in Australia. Opioid initiation post-surgical hospital visit leads to chronic use in a small but significant proportion of patients. Similarly, there are a wide variety of reasons for overprescribing. Awareness of opioid prescription practices locoregionally can advise targeted interventions to change prescribing patterns and reduce the overprescribing of postoperative discharge opioids. The aim of this prospective multi-centre cohort study is to describe the correlation between discharge opioid prescriptions to consumption by patients after common surgical procedures and the impact on patient-reported outcomes.
Interventions
No interventions will be used. Opioiates prescribed and consumed will be determined based on oral morphine equivalents prescribed and consumed at discharge and 7-days.
A study aiming to quantify the amount of opiate medication prescribed at hospital discharge after surgery and identify the proportion of prescription medication consumed by patients at 7-days post-discharge. The study also aims to describe the variations in opioid prescriptions and consumptions by procedure and specialty, quantif
No interventions will be used. Opioiates prescribed and consumed will be determined based on oral morphine equivalents prescribed and consumed at discharge and 7-days. A study aiming to quantify the amount of opiate medication prescribed at hospital discharge after surgery and identify the proportion of prescription medication consumed by patients at 7-days post-discharge. The study also aims to describe the variations in opioid prescriptions and consumptions by procedure and specialty, quantify the impact of quantity of analgesia on patient-reported satisfaction, identify risk factors for opioid consumption and over-prescription at 7-days, and to describe the use of ancillary analgesia after post-discharge after common procedure. Participants that are eligible for inclusion will be approached while they are in hospital and informed consent will be sought. Patient data will be collected through the clinical record while patients are in hospital. At 7-days after patients have been discharged from hospital they will receive a phone-call (preceded by a text-message to introduce the researcher and purpose for the call). The phone call is anticipated to take 10 minutes or less and will ask abou the consumption of analgesia / pain medications in the past 7-day as well as questions about satisfaction regarding pain relief and quality of life questions (via the EQ-5D).
Sponsors
Associate Professor Peter Pockney
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adult patients (greater than or including 18 years of age) Acute or elective surgery Operated on within the pre-specified study periods Discharged to home/community/ usual residence Undergoing any of the following surgeries: General Surgery - Cholecystectomy - Appendicectomy - Inguinal hernia repair - Colon resection with or without stoma - Sleeve gastrectomy Orthopaedic Surgery - Total shoulder arthroplasty/reverse shoulder arthroplasty - Rotator cuff repair/labral repair - ACL repair - Hip arthroplasty - Knee arthroplasty Gynaecology - Hysterectomy - Oophorectomy and/or Salpingectomy Urology - Prostatectomy - Cystectomy - Nephrectomy
Exclusion criteria
Paediatric patients (below 18 years of age) On the opiate replacement programme (on methadone, suboxone, buprenorphine) Patients discharged to hospice or with palliative intent Patients discharged to rehabilitation (including inpatient rehabilitation service), nursing or supported care services, or another hospital, or not discharged should be excluded Diagnostic procedures, e.g., endoscopy, diagnostic laparoscopy (without appendicectomy) Multivisceral resections (defined as operations involving 2 or more distinct procedures of the gastrointestinal, hepatopancreatobiliary, genitourinary, or gynaecological systems e.g. hysterectomy with colorectal resection or any other operation where multiple eligible procedures are included) [to ensure the included standard procedures are internally consistent] Each individual patient should only be included once in the OPERAS study. Return to theatre during the same admission is regarded as a complication and should not form a duplicate entry onto REDCap.
Outcome results
None listed