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Study: 1 in 3 patients don't use prescribed opioids

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A Mayo Clinic survey finds that although 92 percent of patients were prescribed opioid-based pain-killers after surgery, nearly one-third of patients didn’t use their medication.

In total, 63 percent of the opioids prescribed went unused, Mayo found.

The survey results, presented last week at the American Surgical Association annual meeting, provide "a road map for physicians and surgical departments" regarding drug prescriptions, said Elizabeth Habermann, Ph.D., senior author of the study.

"It shows there are certain surgeries and types of patients who are likely receiving significantly more opioids than needed," Habermann said.

In the study, 28 percent of patients said they were prescribed too many opioids. Eight percent said they were prescribed too few.

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The study findings identify factors that can help develop guidelines and optimize opioid prescriptions patients receive after surgery. Based on the new research and previous findings, Mayo has implemented evidence-based opioid prescribing guidelines specific to surgical areas, beginning with orthopedics. There, the guidelines have already led to a considerable reduction in opioid prescriptions — for example, the median amount of prescriptions dropped by half for total knee and total hip surgeries.

This comes at a time when addiction to opioid drugs, in many cases stemming from an initial medical purpose, has become a nationwide health epidemic.

"These new Mayo Clinic guidelines allow prescribers to tailor their prescribing to address the needs of patients who need very little or no opioids, along with those who need more pain control, while still optimizing and reducing prescribing across the board," said lead author Cornelius Thiels, a general surgery resident in the Mayo Clinic School of Graduate Medical Education.

Patient factors associated with a lower use of opioids include older age, no history of anxiety, and a lower pain score at discharge. Factors that could potentially predict the need for more opioids include those younger in age, a history of anxiety and a higher pain score at discharge.

Some other statistics reported from the study include:

  • Only about 8 percent of those patients disposed of their remaining opioids.
  • The median amount of opioids consumed per patient equaled about six pills of 5-milligram oxycodone.
  • Ninety percent of patients said they were satisfied with their pain control.

For the study, researchers and physicians surveyed 1,907 patients who received 25 common surgeries at three academic medical centers.
According to the press release, opioid prescription totals dropped between 2011 and 2015, but were still three times higher in 2015 than in 1999. From 1999 to 2016, five times as many people overdosed and died from opioids, according to the Centers for Disease Control and Prevention.

Reducing the number of opioids prescribed — if they remain unused — will decrease the number that could be used by people to whom they were not prescribed.

Mayo Clinic will partner with the Olmsted County Sheriff’s Office, Olmsted Medical Center, and Zumbro Valley Medical Society on April 28 for a national Prescription Drug Take Back Day event at the west entrance of the Gonda Building.

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