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Comparison of opioid prescribing upon hospital discharge in patients receiving tapentadol versus oxycodone following orthopaedic surgery

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Abstract

Background The changing of opioids during the transition of care from hospital to home may be associated with harm. Objective To compare patients receiving tapentadol IR versus oxycodone IR following orthopaedic surgery during hospitalisation with regard to the changing of opioids at hospital discharge. Setting A major metropolitan tertiary referral hospital in Australia. Methods This is a retrospective cohort study. Participants included adult orthopaedic surgery patients receiving postoperative tapentadol IR or oxycodone IR during hospitalisation between 1 January 2018 and 30 June 2019. Main outcome measure The proportion of patients for whom the opioid prescribed was changed at hospital discharge. Results The study cohort included 199 patients. Of these, 100 patients received oxycodone and 99 patients received tapentadol post-operatively during hospitalisation. The mean age was 66 years (SD, 12 years) and 111 (56%) were female. The most common surgeries were total knee arthroplasty (91, 46%), total hip arthroplasty (63, 32%) and shoulder surgery (26, 13%). Patients in the tapentadol group were more likely to be changed to a different opioid upon hospital discharge than the oxycodone group (57% versus 9%, difference 48% [95% CI 36–59%, p < 0.01). After adjusting for confounders, post-operative tapentadol use was more likely to be associated with opioid changing upon discharge (OR 16.5, 95% CI 6.7 to 40.8, p < 0.01). Conclusions The post-operative use of tapentadol IR during hospitalisation was associated with an increased likelihood of opioid changing at hospital discharge. This practice could have patient safety implications.

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Availability of data and material

The datasets generated during and/or analysed during the current study are not publicly available due to ethical restrictions but are available from the corresponding author on reasonable request.

Code availability

The code of this study is available on request from the corresponding author.

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No funding was obtained for this study.

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Authors and Affiliations

  1. School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Pharmacy and Bank Building A15, Science Road, Camperdown, Sydney, NSW, 2006, Australia

    Xinyi Wang, Hui Ping Tay, Sujita W. Narayan, Jonathan Penm & Asad E. Patanwala

  2. Department of Pharmacy, Royal Prince Alfred Hospital, Sydney, NSW, Australia

    Asad E. Patanwala

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  1. Xinyi Wang
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  2. Hui Ping Tay
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  3. Sujita W. Narayan
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  4. Jonathan Penm
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  5. Asad E. Patanwala
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Correspondence to Asad E. Patanwala.

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Wang, X., Tay, H.P., Narayan, S.W. et al. Comparison of opioid prescribing upon hospital discharge in patients receiving tapentadol versus oxycodone following orthopaedic surgery. Int J Clin Pharm 43, 1602–1608 (2021). https://doi.org/10.1007/s11096-021-01290-7

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  • DOI: https://doi.org/10.1007/s11096-021-01290-7

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