Title: Prolonged oxycodone use and potential risk factors in postoperative patients: A case control study

Abstract

Background: Prolonged exposure to opioids has a negative influence on physical and mental health. Currently,little is known about the risk of prolonging opioids after first postoperative use. Aim: A study was conducted to define the proportion of postoperative patients that use oxycodone longer than prescribed todetermine risk factors of prolonged use. Method: This retrospective single-center nested case–control study was performed in the Elisabeth Tweesteden Hospital, Tilburg, The Netherlands. Thestudy population consisted of postoperative adult patients who received an oxycodone prescription at discharge between April2018 and June 2020. The primary outcome was the proportion of patients with at least one refill of oxycodone during a follow-upperiod of 30 days. The secondary outcome was the association of potential risk factors with oxycodone refills. Univariateand multivariate logistic regression analyses were performed to determine the association between the variables and outcome. Results: 1,203 patients were included of which 280 (23.3%) received one or more refill. Age (adjusted odds ratio 1.01 [95%confidence interval 1.00–1.02]), length of stay (1.10 [1.06–1.14], a Numeric Rating Scale pain score of four or higher (1.52[1.14–2.01]), use of the continuous release form of only (2.15 [1.60–2.89]) and admission to various hospital departments wereassociated with a refill of oxycodone. Conclusion: The proportion of patients with a refill of oxycodone was 23.3%. This could result in chronic oxycodone use and potential misuse. Patients with the determined risk factors may be a suitable population for future interventions to minimize prolonged use.

Biography

Dr. Barbara Maat is clinical pharmacist at the Elisabeth TweeSteden hospital in Tilburg, The Netherlands. She completed her PhD in 2014 (Optimization of electronic prescribingin pediatric patients). Her main fields of interest in clinical practice are pharmacotherapy for surgical patients and pediatric pharmacotherapy. Her scientific work focuses on medication management, medication safety, electronic clinical decision support and technological innovations. Most of her studies have a pharmacoepidemiologic design, but she increasingly uses qualitative research methods in addition.