Evidence map›Paper›PMID 35546657›Full record

ArticleBMC anesthesiology2022

Opioid prescribing practices at hospital discharge for surgical patients before and after the Centers for Disease Control and Prevention's 2016 opioid prescribing guideline.

Erica Langnas, Andrew Bishara, Rhiannon Croci, Rosa Rodriguez-Monguio, Elizabeth C Wick, Catherine L Chen, Zhonghui Guan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC anesthesiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

7 authors at 3 institutions in 1 country.

Erica LangnasDepartment of Anesthesia and Perioperative Care, University of California San Francisco, 513 Parnassus Ave, S455, San Francisco, CA, 94143, USA. erica.langnas@ucsf.edu.
Andrew BisharaDepartment of Anesthesia and Perioperative Care, University of California San Francisco, 513 Parnassus Ave, S455, San Francisco, CA, 94143, USA.
Rhiannon CrociUCSF Health Informatics, University of California San Francisco, San Francisco, CA, USA.
Rosa Rodriguez-MonguioPhilip R. Lee Institute for Health Policy Studies at UCSF, San Francisco, CA, USA.
Elizabeth C WickDepartment of Surgery, University of California San Francisco, San Francisco, CA, USA.
Catherine L Chen *Department of Anesthesia and Perioperative Care, University of California San Francisco, 513 Parnassus Ave, S455, San Francisco, CA, 94143, USA.
Zhonghui Guan *Department of Anesthesia and Perioperative Care, University of California San Francisco, 513 Parnassus Ave, S455, San Francisco, CA, 94143, USA.
University of California, San Francisco · USLee University · USUniversity of California System · US

Funding

Frailty and Monitored Anesthesia Care for Cataract Surgery in Older Adults - Administrative SupplementK23AG072035 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CHEN, CATHERINE LEE · 2021 to 2025
$1.1M
NIA NIH HHS K23 AG072035
6 · The paper itself

Abstract

backgroundThe Centers for Disease Control and Prevention's (CDC) March 2016 opioid prescribing guideline did not include prescribing recommendations for surgical pain. Although opioid over-prescription for surgical patients has been well-documented, the potential effects of the CDC guideline on providers' opioid prescribing practices for surgical patients in the United States remains unclear.

methodsWe conducted an interrupted time series analysis (ITSA) of 37,009 opioid-naïve adult patients undergoing inpatient surgery from 2013-2019 at an academic medical center. We assessed quarterly changes in the discharge opioid prescription days' supply, daily and total doses in oral morphine milligram equivalents (OME), and the proportion of patients requiring opioid refills within 30 days of discharge.

resultsThe discharge opioid prescription declined by -0.021 (95% CI, -0.045 to 0.003) days per quarter pre-guideline versus -0.201 (95% CI, -0.223 to -0.179) days per quarter post-guideline (p < 0.0001). Likewise, the mean daily and total doses of the discharge opioid prescription declined by -0.387 (95% CI, -0.661 to -0.112) and -7.124 (95% CI, -9.287 to -4.962) OME per quarter pre-guideline versus -2.307 (95% CI, -2.560 to -2.055) and -20.68 (95% CI, -22.66 to -18.69) OME per quarter post-guideline, respectively (p < 0.0001). Opioid refill prescription rates remained unchanged from baseline.

conclusionsThe release of the CDC opioid guideline was associated with a significant reduction in discharge opioid prescriptions without a concomitant increase in the proportion of surgical patients requiring refills within 30 days. The mean prescription for opioid-naïve surgical patients decreased to less than 3 days' supply and less than 50 OME per day by 2019.

Indexed as

Analgesics, OpioidPatient DischargeAdultCenters for Disease Control and Prevention, U.S.HospitalsHumansPostoperative PainPractice Patterns, Physicians'United StatesAnalgesics, OpioidHealth policyOpioidsOral morphine equivalentsPost-operative pain

Identifiers

PMID35546657
PMCPMC9097447
OpenAlexW4280597218

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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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.