Patient-Reported Duration of Opioid Analgesic Use After Discharge from Surgical Procedures or Other Types of Acute Pain: A Scoping Review.

Objective: To conduct a scoping literature review of patient-reported duration and amount of post-discharge or outpatient opioid analgesic use for acute pain.

Methods: We searched PubMed for studies, published from January 1, 2017, through June 27, 2022, describing patient-reported opioid analgesic use after discharge from surgical procedures or other types of acute pain. We abstracted and standardized information on the duration (days) and amount of use (converted to 5 mg oxycodone tablets using morphine milligram equivalents).

Results: From 86 studies, we found that duration and amount of opioid analgesic use varied greatly across and within surgical procedures. For some minimally invasive procedures, a minority of patients reported using no opioids. Various factors were associated with the duration or amount of opioid analgesic use, such as preoperative opioid use. Gaps and limitations in the literature include: Few studies assessing non-surgical acute pain and certain specific surgical procedures, and methodologic differences limiting comparability across studies.

Conclusions: Patient-reported data of opioid analgesic use to manage various types of acute pain helps inform opioid prescribing guidelines, but gaps across the existing literature must be carefully considered. We conclude that 1) there is wide variation in patient-reported opioid analgesic use across types of surgical procedures as well as within surgical procedures, potentially driven by patient, surgical, and institutional factors and 2) there continue to be unused tablets prescribed for many types of postsurgical pain, especially for minimally invasive procedures. In part, this work informed the April 2023 Food and Drug Administration's opioid analgesic labeling changes.