Opioid prescribing in post-operative orthopedic patients admitted to inpatient rehabilitation.

Background: Opioid prescribing to post-operative patients in the acute hospital setting is well described; however, little is known about use of opioids in inpatient rehabilitation (IPR) settings. Understanding how opioids are prescribed across all inpatient settings is important to optimize opioid stewardship. The aim of this study was to determine the percentage of post-operative orthopedic patients prescribed opioids and prescribing patterns on discharge from an IPR ward.

Design: Single-center retrospective audit.

Setting: Tertiary metropolitan hospital.

Patients: Patients who underwent an orthopedic surgical procedure between January and July 2020 and were subsequently transferred to an IPR center under the same health service.

Main outcome measures: Opioid prescribing data were obtained at three time points: on admission to the acute hospital, at the time of transfer from the acute hospital to IPR, and at the time of discharge from IPR. Doses were reported in oxycodone equivalent doses.

Results: Of the 117 patients who were included in the audit (median age 84 years, median length of hospital stay 23 days), 115 (98 percent) were prescribed an opioid at the time of discharge from the acute hospital to IPR, and 69 patients (59 percent) were discharged from IPR with a prescription for an opioid.

Conclusions: A significant proportion of patients admitted to IPR were discharged with a prescription for an opioid. Further research is required to determine the appropriateness of continued opioid use in these patients, and ways to reduce the exposure of patients to opioids during and following IPR should be explored.