Evidence map›Paper›PMID 37065538›Full record

ArticleGynecologic oncology reports2023

The past, present, and future of opioid prescribing: Perioperative opioid use in gynecologic oncology patients after laparotomy at a single institution from 2012 to 2021.

Allison H Kay, Alisha Othieno, John Boscardin, Lee-Lynn Chen, Edwin A Alvarez, Megan Swanson, Stefanie Ueda, Lee-May Chen, Jocelyn S Chapman

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Gynecologic oncology reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

9 authors.

Allison H KayDivision of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, United States.
Alisha OthienoDepartment of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, United States.
John BoscardinSchool of Medicine, University of California San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, United States.
Lee-Lynn ChenDepartment of Anesthesia and Perioperative Care, University of California San Francisco, 513 Parnassus, San Francisco, CA 94143, United States.
Edwin A AlvarezDivision of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, United States.
Megan SwansonDivision of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, United States.
Stefanie UedaDivision of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, United States.
Lee-May ChenDivision of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, United States.
Jocelyn S ChapmanDivision of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To describe the evolution of perioperative opioid management in gynecologic oncology patients after open surgeries and determine current opioid over-prescription rates. Methods: Part one of this two-part study was a retrospective chart review of adult patients who underwent laparotomy by a gynecologic oncologist from July 1, 2012 to June 30, 2021, comparing changes in clinical characteristics, pain management and discharge opioid prescription sizes between fiscal year 2012 (FY2012) and 2020 (FY2020). In part two, we prospectively surveyed patients after laparotomy in 2021 to determine opioid use after hospital discharge. Results: 1187 patients were included in the chart review. Demographic and surgical characteristics remained stable from FY2012 to FY2020 with differences notable for increased rates of interval cytoreductive surgeries for advanced ovarian cancer and decreased rates of full lymph node dissection. Median inpatient opioid use decreased by 62 % from FY2012 to FY2020. Median discharge opioid prescription size was 675 oral morphine equivalents (OME) per patient in FY2012 and decreased by 77.7 % to 150 OME in FY2020. Of 95 surveyed patients in 2021, median self-reported opioid use after discharge was 22.5 OME. Patients had an excess of opioids equivalent to 1331 doses of 5-milligram oxycodone tablets per 100 patients. Conclusion: Inpatient opioid use in our gynecologic oncology open surgical patients and post-discharge opioid prescription size significantly decreased over the last decade. Despite this progress, our current prescribing patterns continue to significantly overestimate patients' actual opioid use after hospital discharge. Individualized point of care tools are needed to determine an appropriate opioid prescription size.

Indexed as

Opioid medicationPain managementPerioperative care

Identifiers

PMID37065538
PMCPMC10090236

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.