Relative Frequency and Risk Factors for Prolonged Opioid Therapy after Surgery and Trauma: A Systematic Review and Meta-Analysis

• Main Authors: M Gabrielle Pagé (Author), Irina Kudrina (Author), Patrice Ngangue (Author), Maude Fortier (Author), Elisabeth Martin (Author), Esthelle Ewusi-Boisvert (Author), Hervé T V Zomahoun (Author), Jordie Croteau (Author), Daniela Ziegler (Author), Pierre Beaulieu (Author), Céline Charbonneau (Author), Jennifer Cogan (Author), Raoul Daoust (Author), Marc O Martel (Author), Andrée Néron (Author), Philippe Richebé (Author), Hance Clarke (Author)
• Format: Book
• Published: Taylor & Francis Group, 2019-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2474-0527; 10.1080/24740527.2019.1591853
• Keywords: Medicine (General); R5-920; Therapeutics. Pharmacology; RM1-950
• Source: Canadian Journal of Pain, Vol 0, Iss 0 (2019)

Introduction/Aim: The objectives of this systematic review and meta-analysis were to examine the relative frequency and risk factors (patient, surgical, medical, clinical) for prolonged opioid therapy among surgical and trauma patients. Methods: Studies published in English and French between 1998 and April 2018 examining risk factors for prolonged (3-6 months) or chronic (>6 months) opioid use after surgery/trauma were included. Literature search: seven databases were queried, empirical studies were identified via direct and back citation search, grey literature was also included. A minimum of two independent reviewers assessed studies for inclusion, extracted data and assessed studies quality. Results: Thirty-five out of 10,003 screened articles were included. The median relative frequency of prolonged (50.9%) and chronic (58.5%) opioid therapy among pre-event patients already on opioid therapy was much higher compared to pre-event opioid naïve patients (4.1% and 2.6%, respectively). Tobacco use, depressive disorder and antidepressants use were significant risk factors for prolonged and/or chronic opioid therapy among pre-event opioid naïve patients. Tobacco use, depressive disorder and history of migraines were risk factors for prolonged opioid therapy among pre-event opioid-treated patients. Discussion/Conclusions: Prevention initiatives to reduce the risk of prolonged opioid therapy after surgery or trauma should target specific health behaviors and psychiatric disorders; these interventions should be tailored based on patients' pre-event opioid status.