Postpartum Opioid Prescribing Patterns and Patient Utilization

NCT ID: NCT03030742

Last Updated: 2020-02-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

494 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-06-01

Study Completion Date

2019-12-31

Brief Summary

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This study seeks to investigate the prescribing patterns and patient utilization of opioid pain medication in the postpartum setting. Postpartum women will be surveyed prior to hospital discharge and again at 2-4 weeks postpartum in order to assess the number of opioid tablets they used (in relation to the number prescribed), pain satisfaction, and storage/disposal of any remaining opioid tablets.

Detailed Description

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Opiate abuse is a national epidemic and has paralleled the increase in opioid prescriptions, with diversion of surplus medication playing a key contributing role. As the majority of reproductive age women in the U.S. will experience childbirth, understanding opioid prescription patterns and patient opioid utilization in the postpartum period is critical.

Postpartum women will be recruited during a 9-month period to take part in pre-hospital discharge and 2-4 week postpartum surveys to prospectively assess opioid medication use with regard to quantity of opioid tablets prescribed and quantity used, storage and disposal of unused opioids and satisfaction with pain control.

Conditions

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Postpartum Opioid Use Post-operative Cesarean Delivery

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Post-cesarean delivery

Women who have undergone cesarean delivery

Survey

Intervention Type OTHER

A survey will be administered at two time points (time of hospital discharge and 2-4 weeks postpartum) to determine:

* Satisfaction with pain control 2-4 weeks postpartum
* Patient-reported use of opioid medication postpartum (receipt of prescription, filling of prescription, if refill was obtained, and number of opioid pills remaining at the time of follow-up)
* Patient characteristics associated with high opioid use
* Methods of storage and disposal of unused opioids

Post-vaginal delivery

Women who have undergone vaginal delivery

Survey

Intervention Type OTHER

A survey will be administered at two time points (time of hospital discharge and 2-4 weeks postpartum) to determine:

* Satisfaction with pain control 2-4 weeks postpartum
* Patient-reported use of opioid medication postpartum (receipt of prescription, filling of prescription, if refill was obtained, and number of opioid pills remaining at the time of follow-up)
* Patient characteristics associated with high opioid use
* Methods of storage and disposal of unused opioids

Interventions

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Survey

A survey will be administered at two time points (time of hospital discharge and 2-4 weeks postpartum) to determine:

* Satisfaction with pain control 2-4 weeks postpartum
* Patient-reported use of opioid medication postpartum (receipt of prescription, filling of prescription, if refill was obtained, and number of opioid pills remaining at the time of follow-up)
* Patient characteristics associated with high opioid use
* Methods of storage and disposal of unused opioids

Intervention Type OTHER

Other Intervention Names

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Survey/Questionnaire

Eligibility Criteria

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Inclusion Criteria

* Women who deliver during the recruitment period
* English-speaking
* Opiate-naïve (as determined by admission medication reconciliation)
* Receive oral opioid medications during inpatient postpartum admission
* 18 years or older

Exclusion Criteria

* Contraindication to NSAID use
* Required use of general anesthesia without concurrent neuraxial analgesia
* Undergo hysterectomy, or unanticipated surgical procedures during the postpartum period
* Are admitted to the intensive care unit during their admission.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Society for Maternal-Fetal Medicine

UNKNOWN

Sponsor Role collaborator

Northwestern University

OTHER

Sponsor Role lead

Responsible Party

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Lynn M Yee

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nevert Badreldin, MD

Role: PRINCIPAL_INVESTIGATOR

Northwestern University

Locations

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Northwestern University

Chicago, Illinois, United States

Site Status

Countries

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United States

References

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Centers for Disease Control and Prevention (CDC). Vital signs: overdoses of prescription opioid pain relievers and other drugs among women--United States, 1999-2010. MMWR Morb Mortal Wkly Rep. 2013 Jul 5;62(26):537-42.

Reference Type BACKGROUND
PMID: 23820967 (View on PubMed)

Centers for Disease Control and Prevention (CDC). Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008. MMWR Morb Mortal Wkly Rep. 2011 Nov 4;60(43):1487-92.

Reference Type BACKGROUND
PMID: 22048730 (View on PubMed)

Manchikanti L, Helm S 2nd, Fellows B, Janata JW, Pampati V, Grider JS, Boswell MV. Opioid epidemic in the United States. Pain Physician. 2012 Jul;15(3 Suppl):ES9-38.

Reference Type BACKGROUND
PMID: 22786464 (View on PubMed)

Pfuntner A, Wier LM, Stocks C. Most Frequent Procedures Performed in U.S. Hospitals, 2010. 2013 Feb. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006 Feb-. Statistical Brief #149. Available from http://www.ncbi.nlm.nih.gov/books/NBK132428/

Reference Type BACKGROUND
PMID: 23596641 (View on PubMed)

Peirce GL, Smith MJ, Abate MA, Halverson J. Doctor and pharmacy shopping for controlled substances. Med Care. 2012 Jun;50(6):494-500. doi: 10.1097/MLR.0b013e31824ebd81.

Reference Type BACKGROUND
PMID: 22410408 (View on PubMed)

Bates C, Laciak R, Southwick A, Bishoff J. Overprescription of postoperative narcotics: a look at postoperative pain medication delivery, consumption and disposal in urological practice. J Urol. 2011 Feb;185(2):551-5. doi: 10.1016/j.juro.2010.09.088. Epub 2010 Dec 18.

Reference Type BACKGROUND
PMID: 21168869 (View on PubMed)

Hill MV, McMahon ML, Stucke RS, Barth RJ Jr. Wide Variation and Excessive Dosage of Opioid Prescriptions for Common General Surgical Procedures. Ann Surg. 2017 Apr;265(4):709-714. doi: 10.1097/SLA.0000000000001993.

Reference Type BACKGROUND
PMID: 27631771 (View on PubMed)

Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in Drug and Opioid Overdose Deaths--United States, 2000-2014. MMWR Morb Mortal Wkly Rep. 2016 Jan 1;64(50-51):1378-82. doi: 10.15585/mmwr.mm6450a3.

Reference Type BACKGROUND
PMID: 26720857 (View on PubMed)

Paulozzi LJ, Mack KA, Hockenberry JM; Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC. Vital signs: variation among States in prescribing of opioid pain relievers and benzodiazepines - United States, 2012. MMWR Morb Mortal Wkly Rep. 2014 Jul 4;63(26):563-8.

Reference Type BACKGROUND
PMID: 24990489 (View on PubMed)

Mkontwana N, Novikova N. Oral analgesia for relieving post-caesarean pain. Cochrane Database Syst Rev. 2015 Mar 29;2015(3):CD010450. doi: 10.1002/14651858.CD010450.pub2.

Reference Type BACKGROUND
PMID: 25821010 (View on PubMed)

Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, Carter T, Cassidy CL, Chittenden EH, Degenhardt E, Griffith S, Manworren R, McCarberg B, Montgomery R, Murphy J, Perkal MF, Suresh S, Sluka K, Strassels S, Thirlby R, Viscusi E, Walco GA, Warner L, Weisman SJ, Wu CL. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016 Feb;17(2):131-57. doi: 10.1016/j.jpain.2015.12.008.

Reference Type BACKGROUND
PMID: 26827847 (View on PubMed)

Bateman BT, Franklin JM, Bykov K, Avorn J, Shrank WH, Brennan TA, Landon JE, Rathmell JP, Huybrechts KF, Fischer MA, Choudhry NK. Persistent opioid use following cesarean delivery: patterns and predictors among opioid-naive women. Am J Obstet Gynecol. 2016 Sep;215(3):353.e1-353.e18. doi: 10.1016/j.ajog.2016.03.016. Epub 2016 Mar 17.

Reference Type BACKGROUND
PMID: 26996986 (View on PubMed)

Sun EC, Darnall BD, Baker LC, Mackey S. Incidence of and Risk Factors for Chronic Opioid Use Among Opioid-Naive Patients in the Postoperative Period. JAMA Intern Med. 2016 Sep 1;176(9):1286-93. doi: 10.1001/jamainternmed.2016.3298.

Reference Type BACKGROUND
PMID: 27400458 (View on PubMed)

Bartels K, Mayes LM, Dingmann C, Bullard KJ, Hopfer CJ, Binswanger IA. Opioid Use and Storage Patterns by Patients after Hospital Discharge following Surgery. PLoS One. 2016 Jan 29;11(1):e0147972. doi: 10.1371/journal.pone.0147972. eCollection 2016.

Reference Type BACKGROUND
PMID: 26824844 (View on PubMed)

Other Identifiers

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NortherwesternU

Identifier Type: -

Identifier Source: org_study_id

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