O087 Predictors of persistent opioid use after discharge following colectomy: a population-based cohort study from England

Baamer, R.; Humes, D.J.; Toh, L.; Knaggs, R.; Lobo, D.N.

Abstract

Introduction Little is known regarding whether opioid prescriptions following colectomy lead to persistent use. We aimed to determine the prevalence of persistent post-discharge opioid use following colectomy, stratified by preadmission opioid exposure, and identify associated predictors of prolonged use. Methods This cohort study on adults undergoing colectomy between 2010 and 2019 used linked primary (Clinical Practice Research Datalink), and secondary (Hospital Episode Statistics) care data. Patients were categorised as opioid-naïve, currently exposed (opioid prescription 0-6 months before admission) and prior exposed (prescription 6-12 months before admission). Persistent use was defined as needing an opioid prescription within 90 days of hospital discharge, along with another opioid prescription 91 to 180 days after discharge. Multivariable logistic regression analyses were performed to identify predictors of persistent use. Results Of the 93,262 patients, 15,081 (16.2%) were issued at least one opioid prescription within 90 days of discharge. Of these, 45.0% were opioid-naïve, 49.9% currently exposed, and 5.0% prior exposed. From the whole cohort, 7540 (8.1%) developed persistent opioid use. Patients with preoperative opioid exposure had the highest persistent use: 5317 (40.4%) from the currently exposed group and 305 (9.8%) from the prior exposed group, with only 2.5% from the opioid-naïve group. Predictors of persistent use included prior opioid exposure, high deprivation index, multiple comorbidities, White ethnicity, and open surgery. Conclusion After colectomy, more than 1:12 patients continued to receive opioids three months beyond discharge. Minimally invasive surgery was associated with lower risk of persistent opioid use and may represent a modifiable risk factor.

Citation

Baamer, R., Humes, D., Toh, L., Knaggs, R., & Lobo, D. (2023). O087 Predictors of persistent opioid use after discharge following colectomy: a population-based cohort study from England. British Journal of Surgery, 110(Supplement 3), Article znad101.087. https://doi.org/10.1093/bjs/znad101.087

• Journal Article Type: Meeting Abstract
• Acceptance Date: Feb 19, 2023
• Online Publication Date: May 10, 2023
• Publication Date: May 10, 2023
• Deposit Date: Jun 16, 2023
• Publicly Available Date: May 11, 2024
• Journal: British Journal of Surgery
• Print ISSN: 0007-1323
• Electronic ISSN: 1365-2168
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 110
• Issue: Supplement 3
• Article Number: znad101.087
• DOI: https://doi.org/10.1093/bjs/znad101.087
• Keywords: Surgery
• Public URL: https://nottingham-repository.worktribe.com/output/21098082
• Publisher URL: https://academic.oup.com/bjs/article/110/Supplement_3/znad101.087/7159028
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in BJS following peer review. The version of record R Baamer and others, O087 Predictors of persistent opioid use after discharge following colectomy: a population-based cohort study from England, British Journal of Surgery, Volume 110, Issue Supplement_3, May 2023, znad101.087 is available online at: https://doi.org/10.1093/bjs/znad101.087