Abstract
Background
Limited evidence suggests bariatric surgery may not reduce opioid analgesic use, despite
improvements in pain.
Objective
To determine if use of prescribed opioid analgesics changes in the short and long
term after bariatric surgery and to identify factors associated with continued and
postsurgery initiated use.
Setting
Ten U.S. hospitals.
Methods
The Longitudinal Assessment of Bariatric Surgery-2 is an observational cohort study.
Assessments were conducted presurgery, 6 months postsurgery, and annually postsurgery
for up to 7 years until January 2015. Opioid use was defined as self-reported daily,
weekly, or “as needed” use of a prescribed medication classified as an opioid analgesic.
Results
Of 2258 participants with baseline data, 2218 completed follow-up assessment(s) (78.7%
were female, median body mass index: 46; 70.6% underwent Roux-en-Y gastric bypass).
Prevalence of opioid use decreased after surgery from 14.7% (95% CI: 13.3–16.2) at
baseline to 12.9% (95% CI: 11.5–14.4) at month 6 but then increased to 20.3%, above
baseline levels, as time progressed (95% CI: 18.2–22.5) at year 7. Among participants
without baseline opioid use (n = 1892), opioid use prevalence increased from 5.8%
(95% CI: 4.7–6.9) at month 6 to 14.2% (95% CI: 12.2–16.3) at year 7. Public versus
private health insurance, more pain presurgery, undergoing subsequent surgeries, worsening
or less improvement in pain, and starting or continuing nonopioid analgesics postsurgery
were significantly associated with higher risk of postsurgery initiated opioid use.
Conclusion
After bariatric surgery, prevalence of prescribed opioid analgesic use initially decreased
but then increased to surpass baseline prevalence, suggesting the need for alternative
methods of pain management in this population.
Keywords
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Article info
Publication history
Published online: April 07, 2017
Accepted:
April 4,
2017
Received:
March 31,
2017
Footnotes
☆Authors received funding from the National institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for the study from which the submitted work was produced. Grant numbers: Data Coordinating Center—U01 DK066557, Columbia-Presbyterian—U01-DK66667 (in collaboration with Cornell University Medical Center CTSC, Grant UL1-RR024996), University of Washington—U01-DK66568 (in collaboration with CTRC, Grant M01 RR-00037), Neuropsychiatric Research Institute—U01-DK66471, East Carolina University—U01-DK66526, University of Pittsburgh Medical Center—U01-DK66585 (in collaboration with CTRC, Grant UL1-RR024153), and Oregon Health & Science University—U01-DK66555.
Identification
Copyright
© 2017 Published by Elsevier Inc. All rights reserved.
