Treating of Postoperative Pain with Multiple Opioids Increases Hospital Charges

Treating of Postoperative Pain with Multiple Opioids Increases Hospital Charges

By Staff.

Patients undergoing treatment with multiple opioids for postoperative pain following surgery found that the average hospital charges were higher compared to similar patients who weren’t treated with the same number of opioids, a new study shows.

The study results show that of 17,727 patients, 33 percent were treated with three or more different injectable opioids on the day of surgery.  The average hospital charges for these patients were $2,559 higher compared to similar patients. The study was conducted by CogenDx was presented at the International Society for Pharmacoeconomics and Outcomes Research 22nd Annual International Meeting.

“Previous studies have shown that postoperative pain can lead to adverse events, such as hospital readmissions, and these events can have significant economic consequences,” said Rami Ben-Joseph, PhD, senior vice president, health outcomes research, CogenDx. “Our study adds to the understanding of this problem by showing that cost of care may be higher following inpatient surgeries if patients experience postoperative pain requiring treatment with multiple opioids.”

The study, which utilized billing data from the QuintilesIMS Hospital Charge Data Master database, identified the incidence of postoperative pain requiring treatment with multiple opioids by recording the occurrence of hospital charges for injectable opioids that were administered. Propensity score matching was used to reduce bias that may occur due to the lack of randomization.

“Several factors can impact how patients respond to medication. One factor that hasn’t been fully explored is the role of genetics,” explained Dr. Ben-Joseph. “For example, the OPRM1 gene codes for the μ-opioid receptor, which is a target for opioids, like morphine and fentanyl. There’s clinical evidence that patients with a specific variant of OPRM1 may have higher pain sensitivity. Pharmacogenetics may be able to help identify patients who may be at risk of having unanticipated episodes of postoperative pain.”

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Authored by: Staff

There are 7 comments for this article
  1. Jean Price at 3:04 pm

    Money versus comfort…and faster healing…and, well…it just seems like a ridiculous conclusion! Perhaps those who required multiple opioids has worse conditions or complications from surgery! Why is it always about money?! These are really not even studies…studies involve PATIENTS…looks like these just involve reviewing the ledgers! And then trying to make a wanted conclusion FIT THE PICTURE!! Dumb!

  2. Tim Mason at 8:23 pm

    Sorry staff but this is a ridiculous article. Would using liquor instead and heal amputations in boiling fat?

  3. Joy Collins at 8:01 pm

    Sickening. I know people who are poor and had their gallbladder removed. They were given 1 10/325 vicoden upon discharge. Readmitted due to infection and PAIN.
    When will this SADISM End ????
    Do On To Others, As You Would Have Them Do Unto You.

  4. Bob at 10:30 am

    The good news is that the author is suggesting a test of the OPRM1 gene, prior to surgery, could assist the anaesthesiologist in choosing the correct pain drug for the patient, based on that patient’s capacity to metabolize the drug.

    What would be better news, is if this information was obtained as part of an annual physical exam and kept in the patient’s chart, for reference, if surgery is ever needed in the future. I, for one, am curious how opioid metabolism affects endorphin metabolism. Might the hyperactivity we observe in some children, be the result of a constant struggle to supply themselves with enough endorphin, to keep up with their own metabolism of it? Might childhood hyperactivity be a risk factor for future addiction? Getting at these basic questions requires us to hush our moralizing, stop insulting people for being different, and instead, discover ways to keep people healthy, happy, and coexisting at peace, while accepting the fact that we are all different. If I’m too dumb to figure out why you are different from me, that should be my problem and I should not make it yours.

  5. Jeremy Goodwin, MS, MD at 10:13 am

    This frustrates me. Not everyone responds well to all opioids. Opioids are not always the best option. And they need to be skilfully administered. Patient controlled epidural infusions are often the most effective for select surgeries with PCA pumps providing the same degree of interaction with dosing but which rarely work as well. Nurse provided injections, and possibly the treating clinician’s failure to properly use adjunctive options that are opioid sparing coupled with a failure to address anxiety, medical complications and ultra rapid metabolism of medication can all result in prolonged stays. The fact that three different opioids were used means that such patients’ pain was harder to control in the first place, let alone allow early discharge.

    Yes , some have lower pain thresholds and lower tolerance to pain but there several dozen genetic variants of the main opioid receptor. Some have suffered too long such that the pain has become centralised in the central nervous system prior to surgery. Some surgery fails to alleviate the old pain, adding another. Not all respond optimally to the typically utilised first three or four opioids.

    Why don’t these articles address such things?

  6. Michael G Langley, MD at 8:36 am

    Would those opioids not be used as adjuncts to anesthesia? What about the fact that PCA (patient controlled analgesia), require an electric pump, and all of the costs involved with that? Finally, is this a suggestion that we should not treat post-operative pain?! That would be unethical! Most people, that have abdominal operations, develop a reflex ileus, They are incapable of taking oral medications, thus requiring that IM or IV medications be administered! The study seems very flawed!

  7. Kathy C at 7:27 am

    Here we go again, another Misleading Headline. It really should be obvious that the patients given more medications, and more serious or complicated medical issues, hence they would need more medication and the charges would be higher. This is one more Chicken or egg, argument turned sideways. The Headline implies that the medication is driving the charges, when clearly the severity of the condition would be the reason. Now that we are Post Science, these deliberately misleading Click Bait Articles, are taken at their simplest message.