The following is a summary of “Persistent post-discharge opioid use and opioid stewardship: A single-centre retrospective cohort study,” published in the August 2024 issue of Pain by Hapca et al.

A major public health issue concerning population morbidity and mortality rate has risen due to the use of persistent postoperative opioids. Opioid stewardship was adopted as a strategy to rationalize opioid prescribing and limit harmful use.

Researchers conducted a retrospective study to describe persistent post-discharge opioid use rates and risk factors and to evaluate the role of the Acute Pain Service (APS) in opioid stewardship.

They conducted a 4-year cohort study on inpatients referred to the APS and discharged with new prescriptions for potent opioids. Additionally, an investigation on persistent post-discharge opioid use rates, associated risk factors, and patterns of opioid use after community follow-up by the APS was also done. 

The results showed that 24% of patients discharged with new opioids had persistent opioid use. Risk factors associated with persistent opioid use included female sex (OR: 1.89 [1.11–3.22]; P=0.019), pre-admission mental health history (OR: 2.85 [1.64–4.95]; P<0.001), and pre-admission opioid use (OR: 1.79 [1.03–3.11]; P=0.004). A smaller proportion of patients with APS follow-up in the community developed persistent opioid use of 22%  compared to those without APS follow-up of 32%.

They concluded opioid prescriptions at discharge could lead to persistent opioid use in up to a quarter of patients, APS played an essential role in rationalizing opioid use both during hospital stay and after discharge.

Source: journals.sagepub.com/doi/10.1177/20494637241276106