A Prospective Evaluation of Opioid Consumption Patterns Following Vaginal and Cesarean Deliveries [03E

Abstract

INTRODUCTION: There has been increasing pressure placed on healthcare providers to limit excess narcotic prescription. The purpose of our study is to evaluate opioid prescription and consumption patterns following vaginal and cesarean deliveries. METHODS: This is an IRB-approved prospective observational study conducted at a private academically-affiliated institution. Demographic and delivery information was abstracted from the medical record. Information regarding opioid type and number of pills prescribed and used was collected via telephone survey after discharge. Results are reported as five-milligram (5mg) oxycodone pills. RESULTS: Postpartum opioid utilization is reported for 142 patients. One hundred and one patients received a prescription at discharge. The median number of 5 mg oxycodone pills prescribed after both vaginal and cesarean delivery was 20. The median number of pills used after vaginal and cesarean delivery was 0 and 5, respectively. Of those who filled prescriptions after discharge, the utilization rate after vaginal deliveries was 9.2% and after cesarean deliveries, 43.5%. After 101 deliveries, 1135 opiate pills were unused. There was no relationship between demographics, smoking status, depression/anxiety, use of psychoactive medication, spontaneous versus operative vaginal delivery, planned versus unplanned cesarean delivery, or primary versus repeat cesarean delivery and post-discharge opioid consumption. There were statistically significant relationships between both inpatient opiate use and insurance type with post-discharge opiate consumption. CONCLUSION: Postpartum patients consume 0–40% of prescribed pain medication. Predictive factors of post-discharge opiate use include inpatient consumption and insurance type. Limiting the number of pills prescribed in the postpartum period can decrease excess narcotics available for abuse or diversion.