1-in-3 Patients Skip Post-Surgery Opioids

Patient factors associated with a lower use of opioids include older age, no history of anxiety, and lower pain scores at discharge. Researchers say one-size-fits-all opioid prescribing may not be in patients' best interest.

Nearly one-third of patients at three academic medical centers used none of the opioids they were prescribed after surgery, according to a survey by Mayo Clinic.

Researchers surveyed 1,907 patients who underwent 25 common surgeries at three academic medical centers and found that:

• At discharge, 92% of patients received an opioid prescription.
   
• Of the opioids prescribed, 63% went unused.
   
• 90% of patients were satisfied with their pain control.
   
• 28% said they were prescribed too many opioids; 8% said they were prescribed too few.
   
• The median amount of opioids consumed per patient equaled about six pills of 5-milligram oxycodone.

The number of opioids patients needed after discharge also varied significantly depending on the type of surgery.

"This research provides a road map for physicians and surgical departments. It shows there are certain surgeries and types of patients who are likely receiving significantly more opioids than needed," says study senior author Elizabeth Habermann.   

Patient factors associated with a lower use of opioids include older age, no history of anxiety, and a lower pain score at discharge. Conversely, factors that could potentially predict the need for more opioids include those younger in age, a history of anxiety and a higher pain score at discharge.

"Opioid prescribing guidelines should be based on evidence, considering patient factors and the type of procedure, but also allowing for prescriber discretion," Habermann says.

"This research and numerous other opioid prescribing projects at Mayo Clinic are about identifying the best approach for each individual patient, whether that’s increasing, decreasing or maintaining prescription levels."

Habermann says one-size-fits-all maximums for opioid prescribing that are being advocated by many prescription drug plans and legislators to treat acute pain may not be in patients' best interest.