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Does inpatient opioid use after cesarean delivery predict outpatient opioid use post-discharge?
Abstract Number: F-52
Abstract Type: Original Research
Background: Opioids are the mainstay of both inpatient and outpatient pain control following cesarean delivery (CD), and strategies are needed to better align the amount of opioid prescribed upon discharge with patient need . The aim of this study was to determine if inpatient oxycodone use from 0-72 hours after CD predicts oxycodone consumption after hospital discharge.
Methods: Patients who underwent CD across 6 academic medical centers in the United States between 9/2014 and 3/2016 were surveyed via telephone 2 weeks after discharge regarding their outpatient oral opioid prescription and consumption . In this secondary analysis, inpatient opioid consumption was abstracted for all survey patients from one institution for whom 40 tablets of oxycodone (5mg) were prescribed upon discharge. Multivariate linear regression models were constructed to determine the relationship between inpatient oxycodone use (in mg) from 0-72h and the number of oxycodone 5mg tablets consumed as an outpatient, controlling for (1) patient demographics and comorbidities, (2) procedural characteristics, and (3) in-hospital pain scores, in an additive manner.
Results: One hundred and thirty-three women were included in the analysis. The average age was 33 years; 69% had a primary CD, and 50% had a CD after labor. The median inpatient oxycodone consumption from 0-72h was 65mg (IQR 50-100 mg). The median outpatient oxycodone (5mg tablet) consumption was 20 tablets (IQR 4-35). The association between inpatient and outpatient oxycodone consumption is shown in Figure 1. After controlling for potential confounders, for every 10mg increase in inpatient oxycodone consumption from 0-72h post-CD, women consumed 1.82 additional 5mg tablets after discharge (95% CI: 1.04-2.59, p=<0.001).
Conclusions: Inpatient oxycodone use in the first 72 hours after CD is predictive of outpatient consumption post-discharge. Inpatient oxycodone consumption could potentially be used to inform the quantity of outpatient opioids prescribed at discharge. Better aligning the quantity of opioids prescribed with what patients use may decrease the amount of leftover opioids introduced into communities.
1. Bateman et al. Pharmacoepidemiology and drug safety 2016; 25(Suppl. 3): 3–680.