Relative frequency and risk factors for long-term opioid therapy following surgery and trauma among adults: a systematic review protocol

Pagé, M. Gabrielle; Kudrina, Irina; Zomahoun, Hervé Tchala Vignon; Ziegler, Daniela; Beaulieu, Pierre; Charbonneau, Céline; Cogan, Jennifer; Daoust, Raoul; Martel, Marc O.; Neron, André; Richebé, Philippe; Clarke, Hance

doi:10.1186/s13643-018-0760-3

Cited by 15 publications

(7 citation statements)

References 53 publications

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“…The vast majority did not recall having received information about the addictive nature of opioids, the risk of withdrawal symptoms, or the need for a tapering plan. According to the literature, more than half of trauma patients receive an opioid prescription upon hospital discharge [ 19 , 42 ]. This may already introduce a risk of dependence, because opioid tolerance can develop within only a few weeks of continued use [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Discharge from the trauma centre: exposure to opioids, unmet information needs and lack of follow up—a qualitative study among physical trauma survivors

Finstad

Røise

Rosseland

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Physical trauma is associated with mortality, long-term pain and morbidity. Effective pain management is fundamental in trauma care and opioids are indispensable for treating acute pain; however, the use and misuse of prescribed opioids is an escalating problem. Despite this, few studies have been directed towards trauma patients in an early phase of rehabilitation with focusing on experiences and perspectives of health and recovery including pain and persistent use of prescribed opioids with abuse potential. To explore pre- and post-discharge trauma care experiences, including exposure to opioids, physical trauma survivors were recruited from a major trauma centre in Norway that provides the highest level of surgical trauma care. Method Qualitative exploratory study. Individual semi-structured interviews were conducted among 13 trauma patients with orthopedic injuries, known to be associated with severe pain, six weeks post-discharge. The interviews were recorded, transcribed verbatim, and thematically analyzed with an interdisciplinary approach. Results The overarching theme was that discharge from the trauma centre and the period that immediately followed were associated with feelings of insecurity. The three main themes that were identified as contributing to this was (a) unmet information needs about the injury, (b) exposure to opioids, and (c) lack of follow-up after discharge from the hospital. Participants experienced to be discharged with prescribed opioids, but without information about their addictive properties or tapering plans. This, and lack of attention to mental health and psychological impact of trauma, gave rise to unmet treatment needs of pain management and mental health problems during hospitalization and following discharge. Conclusion The findings from this study suggest that in addition to delivery of high-quality biomedical trauma care, health professionals should direct more attention to psychosocial health and safe pain management, including post-discharge opioid tapering and individually tailored follow-up plans for physical trauma survivors.

show abstract

Section: Discussionmentioning

confidence: 99%

Discharge from the trauma centre: exposure to opioids, unmet information needs and lack of follow up—a qualitative study among physical trauma survivors

Finstad

Røise

Rosseland

et al. 2021

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…In addition, consistent with previous research on “chronic opioid use” and to help ensure that the prescription opioid(s) were prescribed for OA (as opposed to short-term, acute pain), patients were required to have at least 90 days of cumulative supply of opioids during the follow-up period. 12 , 15 Finally, patients were divided into 2 mutually exclusive cohorts based on the index drug: Patients initiated on tramadol or a nontramadol opioid.…”

Section: Methodsmentioning

confidence: 99%

Clinical and economic burden of prescribing tramadol and other opioids for patients with osteoarthritis in a commercially insured population in the United States

Silverman

Rice

White

et al. 2021

Pain

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“…The vast majority did not recall having received information about the addictive nature of opioids, the risk of withdrawal symptoms, or the need for a tapering plan. According to the literature, more than half of trauma patients receive an opioid prescription upon hospital discharge (19,41). This may already introduce a risk of dependence, because opioid tolerance can develop within only a few weeks of continued use (42).…”

Section: Lack Of a Tapering Planmentioning

confidence: 99%

Discharge From the Trauma Hospital as A Transition Into Insecurity, - Experiences Among Physical Trauma Survivors

Finstad¹,

Røise²,

Rosseland³

et al. 2020

Preprint

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Background: Physical trauma is associated with mortality, long-term pain and morbidity. Effective pain management is fundamental in trauma care and opioids are indispensable for treating acute pain; however, the use and misuse of prescribed opioids is an escalating problem. Despite this, few studies have been directed towards trauma patients in an early phase of rehabilitation with focusing on experiences and perspectives of health and recovery including pain and persistent use of prescribed opioids with abuse potential. To explore pre- and post-discharge trauma care experiences, including exposure to opioids, physical trauma survivors were recruited from a major trauma center in Norway that provides the highest level of surgical trauma care. Method: Qualitative exploratory study. Individual semi-structured interviews were conducted among 13 trauma patients with orthopedic injuries, known to be associated with severe pain, six weeks post-discharge. The interviews were recorded, transcribed verbatim, and thematically analyzed with an interdisciplinary approach. Results: The overarching theme was that discharge from the trauma hospital and the period that immediately followed were associated with feelings of insecurity. The three main themes that were identified as contributing to this was a) unmet information needs about the injury, b) exposure to opioids, and c) lack of follow-up after discharge from the hospital. Participants experienced to be discharged with prescribed opioids, but without information about their addictive properties or tapering plans. This, and lack of attention to mental health and psychological impact of trauma, gave rise to unmet treatment needs of pain management and mental health problems during hospitalization and following discharge. Conclusion: The findings from this study suggest that in addition to delivery of high-quality biomedical trauma care, health professionals should direct more attention to psychosocial health and safe pain management, including post-discharge opioid tapering and individually tailored follow-up plans for physical trauma survivors.

show abstract

Relative frequency and risk factors for long-term opioid therapy following surgery and trauma among adults: a systematic review protocol

Cited by 15 publications

References 53 publications

Discharge from the trauma centre: exposure to opioids, unmet information needs and lack of follow up—a qualitative study among physical trauma survivors

Discharge from the trauma centre: exposure to opioids, unmet information needs and lack of follow up—a qualitative study among physical trauma survivors

Clinical and economic burden of prescribing tramadol and other opioids for patients with osteoarthritis in a commercially insured population in the United States

Discharge From the Trauma Hospital as A Transition Into Insecurity, - Experiences Among Physical Trauma Survivors

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