Article Text
Abstract
Background and Aims Background: Data regarding the ‘opioid epidemic’ (chronic opioid use and related admissions secondary to inappropriate prescribing) stems primarily from North American literature. The impact of opioid prescriptions leading to long-term use/dependence has also been assessed in the United Kingdom. Aim: To assess the number of opioid-naïve patients (>=18 years of age) who were discharged on opioids (codeine, oxycodone, tramadol and morphine) by the general surgery department in an NHS trust and to assess for variables that correlate with discharge on opioid medication.
Methods Methods: Records of opioid-naïve adult patients discharged by Buckinghamshire Healthcare NHS Trust General Surgery Department between 1st September 2022 and 30th September 2022 were reviewed and data regarding demographics, management and discharge medications was gathered. Descriptive, Chi2 and tetrachoric (TC) statistical analyses were conducted.
Results Results: 394 patients were discharged in September 2022. 193 male and 201 female. The most common diagnoses were abscess (57), cholelithiasis/cholecystitis (51) and hernia (41). 75 admissions were elective and 319 emergency. 219 cases were managed surgically and 175 conservatively. 48 surgical cases involved laparotomy and 92 laparoscopy. 98 patients were discharged with opioid analgesia (88 codeine, 2 oxycodone, 3 morphine, 5 tramadol). Chi2 testing showed an association between discharge on opioids and admission type (p<0.001, TC=-0.96, correlating with emergency), management (p=0.027, TC=-0.637, weakly correlating with conservative), and surgery type (p=<0.001, TC=-0.97, correlating with laparotomy).
Conclusion A significant portion of surgical patients are discharged on opioids. Future studies will examine for continued opioid use 6 and 12months post-discharge.