ArticleThe Annals of thoracic surgery2019
Impact of Prescribing on New Persistent Opioid Use After Cardiothoracic Surgery.
Article in The Annals of thoracic surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04805229 (Using Difference-in-Differences to Evaluate the Effect of a Statewide Quality Improvement Program on New Persistent Opioid Use After Surgery), which is not on this map. Cited by 41 papers, 2 of them syntheses that pooled it.
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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.
Using Difference-in-Differences to Evaluate the Effect of a Statewide Quality Improvement Program on New Persistent Opioid Use After Surgery
Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Intercostal Nerve Cryoablation Therapy in Thoracic and Cardiac Surgery for Postoperative Pain Management: A Systematic Review and Meta-Analysis.Interdisciplinary cardiovascular and thoracic surgery · 2026Pooled it
- Incidence and risk factors of new persistent opioid use after surgery and trauma: A systematic review.BMC surgery · 2024Pooled it
- Opioid consumption in the first 30 days after surgery was independently associated with new persistent opioid use.Regional anesthesia and pain medicine · 2026Article
- Outpatient opioid use after minimally invasive surgery for lung cancer: a Surveillance, Epidemiology, and End Results-Medicare cohort study.Journal of thoracic disease · 2025Article
- Postoperative Opioid Prescribing Among Adults with Disabilities After a Medicare Opioid Limit Policy.Annals of surgery · 2025Article
- Multimodal Analgesia in Cardiothoracic Procedure: Opioid and Non-opioid Pharmacology for Pain Management: Part 1.Annals of cardiac anaesthesia · 2025Review
- New Persistent Opioid Use After Surgery.JAMA network open · 2025Article
- Development of an implementation intervention to promote adoption of the COMFORT clinical practice guideline for peripartum pain management: a qualitative study.Implementation science communications · 2025Article
- Genetic Associations of Persistent Opioid Use After Surgery Point to OPRM1 but Not Other Opioid-Related Loci as the Main Driver of Opioid Use Disorder.Genetic epidemiology · 2025Article
- Use of opioids and opioid alternatives during general anesthesia: a pan-Canadian survey among anesthesiologists.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Article
- Association Between Intra- and Postoperative Opioids in Opioid-Naïve Patients in Thoracic Surgery.Annals of thoracic surgery short reports · 2024Article
- Article
- Intraoperative pharmacologic opioid minimisation strategies and patient-centred outcomes after surgery: a scoping review.British journal of anaesthesia · 2024Article
- Opioid therapy trajectories of patients with chronic non-cancer pain over 1 year of follow-up after initiation of short-acting opioid formulations.Pain medicine (Malden, Mass.) · 2024Article
- Hospital and long-term opioid use according to analgosedation with fentanyl vs. morphine: Findings from the ANALGESIC trial.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024Article
- The Shining Star of the Last Decade in Regional Anesthesia Part-II: Interfascial Plane Blocks for Cardiac, Abdominal, and Spine Surgery.The Eurasian journal of medicine · 2023Article
- Evidence-based opioid prescribing guidelines after lung resection: a prospective, multicenter analysis.Journal of thoracic disease · 2023Article
- Postoperative Opioid Prescribing and New Persistent Opioid Use: The Risk of Excessive Prescribing.Annals of surgery · 2023Article
- Improving pain management and safe opioid use after surgery: A DMAIC-based quality intervention.Surgery open science · 2023Article
- Clinical Outcomes of Cryo Nerve Ablation Technique for Pain Management: An Exploratory Study in Patients Undergoing Left Thoracotomy Coronary Artery Bypass Grafting.Reviews in cardiovascular medicine · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundNew persistent opioid use occurs in 3% to 14% of patients after elective surgery, but is poorly described after cardiothoracic surgery. We examined the association of prescription size with new persistent opioid use after cardiothoracic surgery.
methodsOpioid-naive Medicare patients undergoing cardiothoracic surgery between 2009 and 2015 were identified. Patients who filled an opioid prescription between 30 days before surgery and 14 days after discharge and with continuous Medicare enrollment 12 months before and 6 months after surgery were selected (n = 24,549). New persistent use was defined as continued prescription fills 91 to 180 days after surgery. Prescription size was reported in oral morphine equivalents. Multivariable regression was performed for risk adjustment, and new persistent use rate was estimated.
resultsPatient age was 71 ± 8 years, 9222 (38%) were female, and 20,898 (85%) were white. Overall new persistent use was 12.8% (3153 of 24,549), and declined yearly from 17% in 2009 to 7.1% in 2015 (P < .001). Prescription size, preoperative prescription fills, black race, gastrointestinal complications, disability status, open lung resection, dual eligibility (Medicare and Medicaid), drug and substance abuse, female sex, tobacco use, high comorbidity, pain disorders, longer hospital stay, and younger age were associated with new persistent use. Adjusted new persistent use was 19.6% (95% confidence interval, 18.7% to 20.4%) among patients prescribed more than 450 oral morphine equivalents, compared with 10.4% (95% confidence interval, 9.9% to 10.8%) among those prescribed 200 oral morphine equivalents or less (P < .001).
conclusionsSize and timing of perioperative opioid prescriptions were the strongest predictors of new persistent opioid use after cardiothoracic surgery. Modifiable risk factors such as prescription size should be targeted to reduce new persistent use.
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