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Post-operative opioid prescription and use in adult cardiac surgery Percy, Edward D.


Introduction: Persistent opioid use following cardiac surgery occurs in up to 13% of opioid naïve patients, however, there is little data available to guide analgesic prescription at the time of discharge. The purpose of this research was to examine opioid prescription in adult cardiac surgery through two specific aims: (i) to characterize current discharge opioid prescribing practices in Canada and the United States, and (ii) to characterize patient-level opioid use patterns in the post-discharge period. Methods: Prescription practices in Canada and the United States were examined through a survey of the Canadian Society of Cardiac Surgeons, and a sample of the Centers for Medicare and Medicaid Services dataset, respectively. Patient-level post-discharge opioid use was assessed in a cohort study of patients undergoing sternotomy-based procedures at a tertiary care hospital. Opioid use over the first 10-days after discharge was collected via diary and confirmed with a follow-up researcher-directed pill count. Results: In our survey of Canadian prescribers, 81% reported routinely prescribing opioids at discharge, however, the medication type and dose were highly variable. Furthermore, there was an association between a lack of formal education in opioid prescription and a higher number of pills prescribed (p

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