Evidence-based opioid prescribing guidelines after lung resection: a prospective, multicenter analysis.
Journal of thoracic disease
BACKGROUND: Opioid prescribing guidelines have significantly decreased overprescribing and post-discharge use after cardiac surgery; however, limited recommendations exist for general thoracic surgery patients, a similarly high-risk population. We examined opioid prescribing and patient-reported use to develop evidence-based, opioid prescribing guidelines after lung cancer resection.
METHODS: This prospective, statewide, quality improvement study was conducted between January 2020 to March 2021 and included patients undergoing surgical resection of a primary lung cancer across 11 institutions. Patient-reported outcomes at 1-month follow-up were linked with clinical data and Society of Thoracic Surgery (STS) database records to characterize prescribing patterns and post-discharge use. The primary outcome was quantity of opioid used after discharge; secondary outcomes included quantity of opioid prescribed at discharge and patient-reported pain scores. Opioid quantities are reported in number of 5-mg oxycodone tablets (mean ± standard deviation).
RESULTS: Of the 602 patients identified, 429 met inclusion criteria. Questionnaire response rate was 65.0%. At discharge, 83.4% of patients were provided a prescription for opioids of mean size 20.5±13.1 pills, while patients reported using 8.2±13.0 pills after discharge (P
CONCLUSIONS: Patient-reported post-discharge opioid use, surgical approach, and in-hospital opioid use before discharge should be used to inform prescribing recommendations after lung resection.
Mondoñedo JR, Brescia AA, Clark MJ, Chang ML, Jiang S, He C, et al [Welsh RJ] Evidence-based opioid prescribing guidelines after lung resection: a prospective, multicenter analysis. J Thorac Dis. 2023 Jun 30;15(6):3285-3294. doi: 10.21037/jtd-22-1621. PMID: 37426143.