Opioid use during the six months following an emergency department visit for acute pain. A prospective cohort study
Abstract
Background: Despite the frequent use of opioids to treat acute pain, the long-term risks and analgesic benefits of an opioid prescription for an individual emergency department (ED) patient with acute pain are still poorly understood and inadequately quantified. Methods: This was a prospective observational cohort study of opioid-naive patients presenting to two EDs for acute pain who were prescribed an opioid at discharge. Patients were followed by telephone six months after the ED visit. Additionally, we reviewed the statewide prescription monitoring program database. Outcomes included frequency of recurrent and persistent opioid use and frequency of persistent moderate or severe pain six months after the ED visit. Persistent opioid use was defined as filling ≥6 prescriptions during the six month study period. Results: During nine months beginning in November 2017, 733 patients were approached for participation. 484 met inclusion criteria and consented to participate. 410 (85%) provided six-month telephone data. The prescription monitoring database was reviewed for all 484 (100%). Most patients (317/484, 66%, 95%CI: 61, 70%) filled only the initial prescription they received in the ED. One in five patients (102/484, 21%, 95%CI: 18, 25%) filled at least 2 prescriptions within the six month period. Five patients (1% 95% CI: 0, 2%) met criteria for persistent opioid use. Of these five patients, all but one reported moderate or severe pain in the affected body part six months…
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