Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

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dc.authorscopusid57221679728
dc.authorscopusid58712743600
dc.authorscopusid58943176300
dc.authorscopusid58942801100
dc.authorscopusid36612315100
dc.authorscopusid57201812375
dc.authorscopusid7404380390
dc.contributor.authorXu W.
dc.contributor.authorSmith N.
dc.contributor.authorTing R.
dc.contributor.authorSoh Q.
dc.contributor.authorSaeed U.
dc.contributor.authorFarrell M.
dc.contributor.authorWright D.
dc.date.accessioned2024-06-12T10:25:16Z
dc.date.available2024-06-12T10:25:16Z
dc.date.issued2024
dc.description.abstractBackground: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures. Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge. Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to sideeffects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (? coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and lowand middle-income countries, patient-reported outcomes did not. Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely. © The Author(s) 2024.en_US
dc.description.sponsorshipMaurice and Phyllis Paykel Trust, MPPT: 213122; Maurice and Phyllis Paykel Trust, MPPT; University of Newcastle Australia, UONen_US
dc.description.sponsorshipOPERAS has received funding from the Maurice and Phyllis Paykel Trust (reference 213122) and the University of Newcastle, Australia.en_US
dc.identifier.doi10.1093/bjs/znad421
dc.identifier.issn0007-1323
dc.identifier.issue1en_US
dc.identifier.pmid38207169en_US
dc.identifier.scopus2-s2.0-85182676823en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1093/bjs/znad421
dc.identifier.urihttps://hdl.handle.net/20.500.14551/16272
dc.identifier.volume111en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.relation.ispartofBritish Journal of Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectMorphine; Opiate; Adult; Analgesia; Article; Cohort Analysis; Elective Surgery; European Quality Of Life 5 Dimensions 5 Level Questionnaire; Female; Follow Up; General Surgery; Gynecologic Surgery; Health Care Personnel; High Income Country; Hospital Discharge; Human; Low Income Country; Male; Middle Income Country; Multicenter Study (Topic); Numeric Rating Scale; Opioid Free Analgesia; Oral Morphine Equivalent; Orthopedic Surgery; Pain Severity; Patient Satisfaction; Patient-Reported Outcome; Postoperative Analgesia; Prescription; Propensity Score; Prospective Study; Side Effect; Therapeutic Equivalence; Urologic Surgeryen_US
dc.titleImpact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countriesen_US
dc.typeArticleen_US

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