Patient and health care provider factors associated with prescription of opioids after delivery
Obstetrics and Gynecology Sep 28, 2018
Badreldin N, et al. - Researchers assessed characteristics of patients and health care providers that correlate with receipt of a high amount of prescribed opioids at postpartum discharge via a retrospective case–control study of 12,362 opioid-naïve women delivering at a single, high-volume tertiary care center between December 1, 2015, and November 30, 2016. They defined a high amount of prescribed opioids as morphine milligram equivalents greater than the 90th percentile (determined as 300 morphine milligram equivalents for vaginal and 500 morphine milligram equivalents for cesarean delivery). High amounts of opioids were prescribed for 7.0% of women who delivered vaginally and 7.3% of those delivering by cesarean. Factors related to a high amount of prescribed opioids at discharge after a vaginal delivery were nulliparity, intrapartum neuraxial anesthesia, major laceration, and infectious complication. Hemorrhage was the only patient factor linked to receipt of a high amount of prescribed opioids in women having a cesarean delivery. Discharge by a trainee physician was associated with reduced odds of receiving a high amount of opioids, even after adjusting for patient factors.
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