EurekaMag
+ Translate
+ Most Popular
The pigeon tick (Argas reflexus): its biology, ecology, and epidemiological aspects
Prevalence of hemoglobin abnormalities in Kebili (Tunisian South)
Lipogranuloma: a preventable complication of dacryocystorhinostomy
Value of basal plasma cortisol assays in the assessment of pituitary-adrenal insufficiency
Bees from the Belgian Congo. The acraensis group of Anthophora
Placing gingival retraction cord
Total serum IgE, allergy skin testing, and the radioallergosorbent test for the diagnosis of allergy in asthmatic children
Acariens plumicoles Analgesoidea parasites des oiseaux du Maroc
Injuries of terminal phalanges of the fingers in children
Biology of flowering and nectar production in pear (Pyrus communis)
Das Reliktvorkommen der Aspisviper (Vipera aspis L.) im Schwarzwald
Hydrological modelling of drained blanket peatland
Pathologic morphology and clinical significance of the anomalous origin of the left circumflex coronary artery from the right coronary artery. General review and autopsy analysis of 30 cases
Cyto genetic analyses of lymphocyte cultures after exposure to calcium cyclamate
Axelrodia riesei, a new characoid fish from Upper Rio Meta in Colombia With remarks concerning the genus Axelrodia and description of a similar, sympatric, Hyphessobrycon-species
Favorable evolution of a case of tuberculosis of pancreas under antibiotic action
RIFM fragrance ingredient safety assessment, Valencene, CAS Registry Number 4630-07-3
Parenteral microemulsions: an overview
Temperate pasture: management for grazing and conservation
Evaluation of a new coprocessed compound based on lactose and maize starch for tablet formulation
Thermal expansion and cracking of three confined water-saturated igneous rocks to 800C
Revision of the genera of the tribe Stigmoderini (Coleoptera: Buprestidae) a discussion of phylogenetic relationships
Anal tuberculosis. Report of a case
Gastric tuberculosis in the past and present
Adaptive responses of the cardiovascular system to prolonged spaceflight conditions: assessment with Holter monitoring

Time-to-Cessation of Postoperative Opioids: A Population-Level Analysis of the Veterans Affairs Health Care System


Time-to-Cessation of Postoperative Opioids: A Population-Level Analysis of the Veterans Affairs Health Care System



Pain Medicine 17(9): 1732-1743



ISSN/ISBN: 1526-2375

PMID: 27084410

DOI: 10.1093/pm/pnw015

This study aims to determine 1) the epidemiology of perioperative opioid use; and 2) the association between patterns of preoperative opioid use and time-to-cessation of postoperative opioids. Retrospective, cohort study. National, population-level study of Veterans Healthcare Administration (VHA) electronic clinical data. All VHA patients (n = 64,391) who underwent surgery in 2011, discharged after stays of ≥1 day, and receiving ≥1 opioid prescription within 90 days of discharge. Patients' preoperative opioid use were categorized as 1) no opioids, 2) tramadol only, 3) short-acting (SA) acute/intermittent (≤ 90 days fill), 4) SA chronic (> 90 days fill), or 5) any long-acting (LA). After defining cessation as 90 consecutive, opioid-free days, the authors calculated time-to-opioid-cessation (in days), from day 1 to day 365, after hospital discharge. The authors developed extended Cox regression models with a priori identified predictors. Sensitivity analyses used alternative cessation definitions (30 or 180 consecutive days). Almost 60% of the patients received preoperative opioids: tramadol (7.5%), SA acute/intermittent (24.1%), SA chronic (17.5%), and LA (5.2%). For patients opioid-free preoperatively, median time-to-cessation of opioids postoperatively was 15 days. The SA acute/intermittent cohort (HR =1.96; 95% CI =1.92-2.00) had greater risk for prolonged time-to-cessation than those opioid-free (reference), but lower risk than those taking tramadol only, SA chronic (HR = 9.09; 95% CI = 8.33-9.09), or LA opioids (HR = 9.09; 95% CI = 8.33-10.00). Diagnoses of chronic pain, substance-use, or affective disorders were weaker positive predictors. Sensitivity analyses maintained findings. Greater preoperative levels of opioid use were associated with progressively longer time-to-cessation postoperatively.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059135496

Download citation: RISBibTeXText

Related references

Postdeployment Polytrauma Diagnoses Among Soldiers and Veterans Using the Veterans Health Affairs Polytrauma System of Care and Receipt of Opioids, Nonpharmacologic, and Mental Health Treatments. Journal of Head Trauma Rehabilitation 34(3): 167-175, 2019

Smoking cessation among African American and white smokers in the Veterans Affairs health care system. American journal of public health 104(Suppl): S580-S587, 2014

Inpatient rehabilitation after stroke: a comparison of lengths of stay and outcomes in the Veterans Affairs and non-Veterans Affairs health care system. Medical Care 39(2): 123-137, 2001

Stress Testing After Percutaneous Coronary Intervention in the Veterans Affairs Health Care System: Insights from the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program. Circulation. Cardiovascular Quality and Outcomes 8(5): 486-492, 2015

Transforming the Veterans Affairs to a Whole Health System of Care: Time for Action and Research. Medical Care 58(4): 295-300, 2020

Utilization of primary care by veterans with psychiatric illness in the National Department of Veterans Affairs Health Care System. Journal of general internal medicine 23(11): 1835-1840, 2008

Burden of COPD in a government health care system: a retrospective observational study using data from the US Veterans Affairs population. International Journal of Chronic Obstructive Pulmonary Disease 5: 125-132, 2010

Primary care-mental health integration programs in the veterans affairs health system serve a different patient population than specialty mental health clinics. Primary Care Companion for Cns Disorders 14(3), 2012

Patient characteristics associated with the level of patient-reported care coordination among male patients with colorectal cancer in the Veterans Affairs health care system. Cancer 121(13): 2207-2213, 2015

Utilization of Care Outside the Veterans Affairs Health Care System by US Veterans With Rheumatoid Arthritis. Arthritis Care and Research 69(6): 776-782, 2017

National dissemination of cognitive behavioral therapy for depression in the Department of Veterans Affairs health care system: therapist and patient-level outcomes. Journal of consulting and clinical psychology 80(5): 707-718, 2012

Treatment of dupuytren disease with injectable collagenase in a veteran population: a case series at the department of veterans affairs new jersey health care system. Eplasty 14: e13, 2014

Use of Medicare and Department of Veterans Affairs health care by veterans with dementia: a longitudinal analysis. Journal of the American Geriatrics Society 57(10): 1908-1914, 2009

Adherence to appropriateness criteria for transthoracic echocardiography: comparisons between a regional department of Veterans Affairs health care system and academic practice and between physicians and mid-level providers. Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 22(7): 793-799, 2009

Using cost-effectiveness analysis to sharpen formulary decision-making: the example of tiotropium at the Veterans Affairs health care system. Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research 11(5): 980-988, 2008