MP23-02 UNDERSTANDING SHORT AND LONG-TERM OPIOID AND BENZODIAZEPINE PERI-OPERATIVE CONVERSION RATES IN PRESCRIPTION-NAÏVE RADICAL CYSTECTOMY PATIENTS

Abstract

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making III (MP23)1 Sep 2021MP23-02 UNDERSTANDING SHORT AND LONG-TERM OPIOID AND BENZODIAZEPINE PERI-OPERATIVE CONVERSION RATES IN PRESCRIPTION-NAÏVE RADICAL CYSTECTOMY PATIENTS W. Blair Townsend, Emily Baldrige, Myra Robinson, Emily Roebuck, William M. Worrilow, Megan McDonald, Jared Brown, Caroline Lu, Samuel Ivan, Stephen B. Riggs, and PRIMUM Group W. Blair TownsendW. Blair Townsend More articles by this author , Emily BaldrigeEmily Baldrige More articles by this author , Myra RobinsonMyra Robinson More articles by this author , Emily RoebuckEmily Roebuck More articles by this author , William M. WorrilowWilliam M. Worrilow More articles by this author , Megan McDonaldMegan McDonald More articles by this author , Jared BrownJared Brown More articles by this author , Caroline LuCaroline Lu More articles by this author , Samuel IvanSamuel Ivan More articles by this author , Stephen B. RiggsStephen B. Riggs More articles by this author , and PRIMUM Group More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002014.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Limited data exist on the association of preoperative opioid and benzodiazepine (benzo) use on continued postoperative utilization in radical cystectomy (RC) patients. We sought to summarize our clinical experience with perioperative opioid and benzo use in RC patients and examine the impact of RC on long-term opioid or benzo use in prescription-naïve RC patients. METHODS: This retrospective study reviewed pre- and post-RC opioid and benzo use data from a clinical decision support intervention tool that identifies risk factors for misuse, abuse, and diversion. Primary outcomes included conversion rates of pre-operative opioid and benzo-naïve RC patients (no prescription within 1 year prior to RC) to long-term use post discharge ( >1 prescription within 3-12 mo. of discharge). Additionally, measures of opioid and benzo use [measured by any prescription, average # orders/month, and average MME/month (for opioids)] were summarized and compared between pre-RC period and short term (≤3 mo. post discharge) and long term (>3 mo. to 12 mo. post-discharge) post-RC periods. McNemar tests for agreement and Wilcoxon signed rank tests were utilized. RESULTS: From 01/2017 - 01/2020, 178 patients underwent RC at our high-volume institution. Of 85 (48%) “opioid naïve” patients, 11 (13%) converted to long-term post-RC opioid use. Of 160 (90%) “benzo naïve” patients, 2 (1%) converted to long-term post-RC benzo use. The rate of opioid use was significantly higher in the short-term post-RC period compared to pre-RC (83% v. 52%, p <0.01). Conversely, the rate of opioid use was significantly lower in the long-term post-RC period compared to pre-RC (25% v. 52%, p <0.01, Table 1). For benzos, both short term (5%) and long term (2%) post-RC benzo use were significantly lower than pre-RC benzo use (10%, p=0.03 and p <0.01, respectively). CONCLUSIONS: Overall, our study found 13% of opioid naïve subjects converted to long term post-RC opioid use, and 1% of benzo naïve patients converted to long-term post-RC benzo use. Future work is needed to understand conversion rates in a larger cohort of RC patients and to identify solutions to minimize unnecessary opioid and benzo use in surgical patients. Source of Funding: Supported in part by a cooperative agreement (CE14-004 Award # CE002520) from the CDC © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e400-e401 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information W. Blair Townsend More articles by this author Emily Baldrige More articles by this author Myra Robinson More articles by this author Emily Roebuck More articles by this author William M. Worrilow More articles by this author Megan McDonald More articles by this author Jared Brown More articles by this author Caroline Lu More articles by this author Samuel Ivan More articles by this author Stephen B. Riggs More articles by this author PRIMUM Group More articles by this author Expand All Advertisement Loading ...