Evidence map›Paper›PMID 30095773›Full record

Trial reportObstetrics and gynecology2018

Individualized Compared With Standard Postdischarge Oxycodone Prescribing After Cesarean Birth: A Randomized Controlled Trial.

Sarah S Osmundson, Britany L Raymond, Bradley T Kook, LeAnn Lam, Elizabeth B Thompson, Leslie A Schornack, Catherine E Voorhees, Michael G Richardson

Registry-linked trialAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Obstetrics and gynecology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03168425 (A Randomized Controlled Trial to Improve Discharge Opioid Prescribing After Cesarean Delivery), which is not on this map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03168425 nacompletednot on this map

A Randomized Controlled Trial to Improve Discharge Opioid Prescribing After Cesarean Delivery

TypeinterventionalSponsorVanderbilt University Medical CenterRan2017 to 2017Enrolled190ConditionsSurgery, Opioid UseArmsTailored prescription, Control
3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Maternal psychosocial factors associated with postpartum pain.American journal of obstetrics & gynecology MFM · 2023
    Observational
  11. Article
  12. Review
  13. Article
  14. Observational
  15. Longitudinal patient-reported outcomes and restrictive opioid prescribing after minimally invasive gynecologic surgery.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2021
    Article
  16. Article
  17. Review
  18. Review
  19. Article
  20. Opioid prescribing after childbirth: overprescribing and chronic use.Current opinion in obstetrics & gynecology · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Sarah S OsmundsonDepartments of Obstetrics and Gynecology and Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; the University of Utah, Salt Lake City, Utah; and Vanderbilt University, Nashville, Tennessee.
Britany L Raymond
Bradley T Kook
LeAnn Lam
Elizabeth B Thompson
Leslie A Schornack
Catherine E Voorhees
Michael G Richardson
Vanderbilt University Medical Center · US

Funding

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Building Interdisciplinary Research Careers in Women's HealthK12HD043483 · NICHD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI HARTMANN, KATHERINE E, MAJOR, AMY S · 2002 to 2023
$10.3M
Opioid selection and the risk of serious infections in older adultsR01AG043471 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI GRIJALVA, CARLOS G · 2013 to 2017
$2.3M
NCATS NIH HHS UL1 TR000445NIA NIH HHS R01 AG043471NICHD NIH HHS K12 HD043483
6 · The paper itself

Abstract

objectiveTo evaluate whether individualized postdischarge oxycodone prescribing guided by inpatient opioid use reduces the number of unused opioid tablets after cesarean birth.

methodsWe conducted a randomized, controlled trial of women aged 18 years or older undergoing cesarean birth. Participants were randomized at discharge in a 1:1 ratio to a standard (30 tablets of 5 mg oxycodone) or an individualized oxycodone prescription (predicted based on each patient's inpatient opioid use). All women were contacted starting 14 days after cesarean birth to assess number of oxycodone tablets used and adequacy of pain control. The Tennessee Controlled Substance Monitoring Database was accessed to confirm dispensed opioids. The primary outcome was number of unused oxycodone tablets prescribed for pain control after cesarean birth. A total sample size of 160 women was necessary to detect a 30% difference in leftover tablets between groups with 80% power and α of 0.05.

resultsBetween June 14, 2017, and August 26, 2017, we screened 323 women and randomized 172. Baseline characteristics and inpatient opioid use were similar between groups. Women in the individualized group were prescribed fewer tablets (14 [interquartile range 12-16] vs 30 [interquartile range 30-30], P<.001) and had 50% fewer unused tablets than women in the standard group (5 [interquartile range 1-8] vs 10 [interquartile range 0-22], P<.001). Overall, 13% (23/172) used no opioids after discharge and 26% (44/172) used all prescribed opioids. There were no differences between the standard and individualized groups in the proportion of women who used no opioids or all opioids and no difference in the proportion of dispensed opioids used (60% [interquartile range 23-100] vs 61% [29-89], P=.93). Women in the individualized group used only half the number of prescribed opioids as women in the standard group (8 [interquartile range 4-14] vs 15 [interquartile range 6-30], P<.001). Patient-reported pain outcomes did not differ significantly by group.

conclusionIndividualized opioid prescribing based on inpatient use reduces the number of unused oxycodone tablets compared with standard prescribing. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov, NCT03168425.

Indexed as

AdultAnalgesics, OpioidCesarean SectionFemaleHumansOxycodonePatient DischargePostoperative PainPractice Patterns, Physicians'Precision MedicinePregnancyYoung AdultAnalgesics, OpioidOxycodone

Identifiers

PMID30095773
PMCPMC6105453
OpenAlexW2886099178

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.