{"id":19894,"date":"2024-06-26T11:37:00","date_gmt":"2024-06-26T15:37:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=19894"},"modified":"2024-07-25T11:41:16","modified_gmt":"2024-07-25T15:41:16","slug":"postdischarge-opioid-use-after-lumbar-spine-surgery-among-older-adults-in-ontario","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/postdischarge-opioid-use-after-lumbar-spine-surgery-among-older-adults-in-ontario\/","title":{"rendered":"Postdischarge opioid use after lumbar spine surgery among older adults in Ontario: a population-based cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Prescription opioid use places a considerable economic burden on health care systems. Older patients undergoing surgical procedures for painful conditions commonly receive opioids pre- and postoperatively, and are susceptible to adverse reactions. This study explores predictors of prolonged postoperative opioid use among older patients after lumbar spine surgery and the consequences in terms of health care utilization and costs.<\/p>\n<p><strong>Methods<\/strong> \u2014 We conducted a retrospective population-based cohort study using Ontario administrative data from older adults undergoing spine surgery between 2006 and 2017. Data were analyzed from 90 days preoperatively to 1 year after hospital discharge, with last postoperative opioid prescriptions stratified into 90-day increments. We used multivariable ordinal logistic regression to identify predictors of long-term opioid use and generalized linear modelling to examine resource utilization and health care costs (2021 Canadian dollars).<\/p>\n<p><strong>Results<\/strong> \u2014 Of 15 109 patients included, 40.8% received preoperative opioid prescriptions. Preoperative opioid use strongly predicted prolonged postoperative use (odds ratio [OR] 4.47, 95% confidence interval [CI] 4.16-4.79), with 48.3% of patients who received preoperative opioids continuing to use opioids for longer than 9 months, relative to 12.7% of those without preoperative use. Several other risk factors for prolonged use were identified. Patients receiving long-term postoperative opioids incurred greater health care costs relative to those with opioids prescribed for fewer than 90 days (OR 1.49, 95% CI 1.44-1.54).<\/p>\n<p><strong>Conclusion<\/strong> \u2014 Among older adults undergoing spine surgery, preoperative opioid use was a strong predictor of prolonged postoperative use, which was associated with increased health care costs. These results form an important baseline for future studies evaluating strategies to reduce opioid use targeting older surgical populations.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Prescription opioid use places a considerable economic burden on health care systems. Older patients undergoing surgical procedures for painful conditions commonly receive opioids pre- and postoperatively, and are susceptible to adverse reactions. This study explores predictors of prolonged postoperative opioid use among older patients after lumbar spine surgery and the consequences in terms [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[17,56,25],"migration-helper-qa-sample-set":[],"class_list":["post-19894","journal_article","type-journal_article","status-publish","hentry","topic-older-people","topic-pharmacoepidemiology-and-drug-safety","topic-surgery"],"acf":{"citation":"Johnson A, Nguyen F, Richardson M, Rabi S, Mann S, Gilron I, Yach J, Milne B, Evans G, Parlow J. <em>Can J Surg<\/em>. 2024; 67(3):E252-E260. Epub 2024 Jun 26.","source_url":"https:\/\/doi.org\/10.1503\/cjs.003723","ices_scientist":[1279,1226],"site":[6736],"research_program":[6741],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Postdischarge opioid use after lumbar spine surgery among older adults in Ontario: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Prescription opioid use places a considerable economic burden on health care systems. 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