Evidence map›Paper›PMID 36418792›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2023

Opioid prescribing practices and patient-requested refill patterns following laparoscopic inguinal hernia repair.

C K Gentle, J D Thomas, K C Montelione, C Tu, A S Prabhu, D M Krpata, L R Beffa, S Rosenblatt, M J Rosen, E Lo Menzo and 4 more

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

Article in Hernia : the journal of hernias and abdominal wall surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. 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

14 authors at 4 institutions in 1 country.

C K GentleDepartment of General Surgery, Digestive Disease and Surgery Institute, Center for Abdominal Core Health, Cleveland Clinic, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA. gentlec@ccf.org.ORCID 0000-0003-1001-4185
J D ThomasDepartment of Surgery, Massachusetts General Hospital, Boston, MA, USA.
K C MontelioneDepartment of General Surgery, Digestive Disease and Surgery Institute, Center for Abdominal Core Health, Cleveland Clinic, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA.
C TuDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
A S PrabhuDepartment of General Surgery, Digestive Disease and Surgery Institute, Center for Abdominal Core Health, Cleveland Clinic, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA.
D M KrpataDepartment of General Surgery, Digestive Disease and Surgery Institute, Center for Abdominal Core Health, Cleveland Clinic, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA.
L R BeffaDepartment of General Surgery, Digestive Disease and Surgery Institute, Center for Abdominal Core Health, Cleveland Clinic, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA.
S RosenblattDepartment of General Surgery, Digestive Disease and Surgery Institute, Center for Abdominal Core Health, Cleveland Clinic, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA.
M J RosenDepartment of General Surgery, Digestive Disease and Surgery Institute, Center for Abdominal Core Health, Cleveland Clinic, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA.
E Lo MenzoDepartment of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Florida, Weston, FL, USA.
D AlaedeenDepartment of General Surgery, Fairview Hospital, Cleveland, OH, USA.
S SzomsteinDepartment of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Florida, Weston, FL, USA.
C G MassierDepartment of General Surgery, Marymount Hospital, Garfield Heights, OH, USA.
C C PetroDepartment of General Surgery, Digestive Disease and Surgery Institute, Center for Abdominal Core Health, Cleveland Clinic, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA. petroc@ccf.org.
Cleveland Clinic · USCleveland Clinic Florida · USFairview Southdale Hospital · USMassachusetts General Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeExcessive post-operative opioid prescribing has led to efforts to match prescriptions with patient need after surgery. We investigated opioid prescribing practices, rate of patient-requested opioid refills, and associated factors after laparoscopic inguinal hernia repair (LIHR).

methodsLIHRs at a single institution from 3/2019 to 3/2021 were queried from the Abdominal Core Health Quality Collaborative for demographics, perioperative details, and patient-reported opioid usage. Opioid prescriptions at discharge and opioid refills were extracted from the medical record. Univariate and multivariable regression were used to identify factors associated with opioid refills within 30-days of surgery.

resultsFour hundred and ninety LIHR patients were analyzed. The median number of opioid tablets prescribed was 12 [interquartile range (IQR) 10-15], and 4% requested a refill. On univariate analysis, patients who requested refills were younger [55 years (IQR 37-61) vs. 62 years (IQR 36.8-61), p = 0.012], more likely to have undergone transabdominal preperitoneal repair (75% vs. 26.4%, p < 0.001), have a scrotal component (30% vs. 11%, p = 0.022), and have permanent tacks used (80% vs. 49.4%, p = 0.014). There was a 12% increase in the odds of opioid refill for every 1 tablet of oxycodone prescribed at discharge (95% CI for OR 1.04-1.21, p = 0.003) after controlling for age and surgery type. Patient-reported opioid use was available for 289 (59%) patients. Post-operatively, 67% of patients used ≤ 4 opioid tablets, and 87% used no more than 10 opioid tablets.

conclusionMost patients use fewer opioid tablets than prescribed. Requests for opioid refills are rare following LIHR (4%) and associated with higher opioid prescribing.

Indexed as

Hernia, InguinalLaparoscopyAnalgesics, OpioidHerniorrhaphyHumansMalePostoperative PainPractice Patterns, Physicians'Retrospective StudiesAnalgesics, OpioidLaparoscopic inguinal hernia repairOpioid refillsOpioidsPatient-reported outcomesPost-operative pain

Identifiers

PMID36418792
PMCPMC9685134
OpenAlexW4309890370

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.