TY - JOUR
T1 - Appropriate Opioid Use After Spine Surgery
T2 - Psychobehavioral Barriers and Patient Knowledge
AU - Rahman, Rafa
AU - Wallam, Sara
AU - Zhang, Bo
AU - Sachdev, Rahul
AU - McNeely, Emmanuel L.
AU - Kebaish, Khaled M.
AU - Riley, Lee H.
AU - Cohen, David B.
AU - Jain, Amit
AU - Lee, Sang H.
AU - Sciubba, Daniel M.
AU - Skolasky, Richard L.
AU - Neuman, Brian J.
N1 - Funding Information:
Conflict of interest statement: This publication was made possible by the Johns Hopkins Institute for Clinical and Translational Research , which is funded in part by grant number TL1TR003100 from the National Center for Advancing Translational Sciences , a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins Institute for Clinical and Translational Research, National Center for Advancing Translational Sciences, or the NIH. Data collection for this work was funded in whole or in part with funds from the Agency for Healthcare Research and Quality , National Institutes of Health , and Department of Health and Human Services , under Contracts R03HS016106 and R01HS017990. Role of funder: the funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Sponsors also had no right to veto publication or to control the decision regarding to which journal the article was submitted.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/6
Y1 - 2021/6
N2 - Objective: To identify spine patients' barriers to appropriate postoperative opioid use, comfort with naloxone, knowledge of safe opioid disposal practices, and associated factors. Methods: We preoperatively surveyed 174 spine patients about psychobehavioral barriers to appropriate opioid use, comfort with naloxone, and knowledge about opioid disposal. Multivariable logistic regression identified factors associated with barriers and knowledge (α = 0.05). Results: Common barriers were fear of addiction (71%) and concern about disease progression (43%). Most patients (78%) had neutral/low confidence in the ability of nonopioid medications to control pain; most (57%) felt neutral or uncomfortable with using naloxone; and most (86%) were familiar with safe disposal. Anxiety was associated with fear of distracting the physician (adjusted odds ratio [aOR], 3.8; 95% confidence interval [CI], 1.1–14) and with lower odds of knowing safe disposal methods (aOR, 0.18; 95% CI, 0.04–0.72). Opioid use during the preceding month was associated with comfort with naloxone (aOR, 4.9; 95% CI, 2.1–12). Patients with a higher educational level had lower odds of reporting fear of distracting the physician (aOR, 0.30; 95% CI, 0.09–0.97), and those with previous postoperative opioid use had lower odds of concern about disease progression (aOR, 0.25; 95% CI, 0.09–0.63) and with a belief in tolerating pain (aOR, 0.34; 95% CI, 0.12–0.95). Conclusions: Many spine patients report barriers to appropriate postoperative opioid use and are neutral or uncomfortable with naloxone. Some are unfamiliar with safe disposal. Associated factors include anxiety, lack of recent opioid use, and no previous postoperative use.
AB - Objective: To identify spine patients' barriers to appropriate postoperative opioid use, comfort with naloxone, knowledge of safe opioid disposal practices, and associated factors. Methods: We preoperatively surveyed 174 spine patients about psychobehavioral barriers to appropriate opioid use, comfort with naloxone, and knowledge about opioid disposal. Multivariable logistic regression identified factors associated with barriers and knowledge (α = 0.05). Results: Common barriers were fear of addiction (71%) and concern about disease progression (43%). Most patients (78%) had neutral/low confidence in the ability of nonopioid medications to control pain; most (57%) felt neutral or uncomfortable with using naloxone; and most (86%) were familiar with safe disposal. Anxiety was associated with fear of distracting the physician (adjusted odds ratio [aOR], 3.8; 95% confidence interval [CI], 1.1–14) and with lower odds of knowing safe disposal methods (aOR, 0.18; 95% CI, 0.04–0.72). Opioid use during the preceding month was associated with comfort with naloxone (aOR, 4.9; 95% CI, 2.1–12). Patients with a higher educational level had lower odds of reporting fear of distracting the physician (aOR, 0.30; 95% CI, 0.09–0.97), and those with previous postoperative opioid use had lower odds of concern about disease progression (aOR, 0.25; 95% CI, 0.09–0.63) and with a belief in tolerating pain (aOR, 0.34; 95% CI, 0.12–0.95). Conclusions: Many spine patients report barriers to appropriate postoperative opioid use and are neutral or uncomfortable with naloxone. Some are unfamiliar with safe disposal. Associated factors include anxiety, lack of recent opioid use, and no previous postoperative use.
KW - Opioid knowledge
KW - Pain control
KW - Postoperative opioid use
UR - http://www.scopus.com/inward/record.url?scp=85104068960&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2021.03.066
DO - 10.1016/j.wneu.2021.03.066
M3 - Article
C2 - 33753317
AN - SCOPUS:85104068960
SN - 1878-8750
VL - 150
SP - e600-e612
JO - World neurosurgery
JF - World neurosurgery
ER -