Satisfaction with opioid prescription and use after minor gynaecologic surgery: a pilot prospective study

Figures & data

Table 2. Patient satisfaction and postoperative characteristics by opioid prescription.

	Postoperative day 1–2			Postoperative day 14
	Opioids prescription			Opioids prescription
	Yes N = 82	No N = 65	p Value	Yes N = 82	No N = 65	p Value
Satisfaction
Satisfaction with care^a	5 (5–5)	5 (4–5)	.16	5 (5–5)	5 (5–5)	.41
Pain satisfaction scale^b	10 (8–10)	10 (8–10)	.97	10 (9–10)	10 (9–10)	.55
Frequency spent in severe pain^c	2 (1–4)	1 (1–3)	.04	2 (1–4)	1 (1–2)	.03
Pain interference with activities^d	2(1–4)	1 (1–4)	.18	3 (1–4)	1 (1–3)	.0003
Percent amount pain relief^e	8 (5–9)	9 (5–10)	.20	9 (8–10)	9 (3–10)	.42
Shared decision making about pain relief^f	9 (2–10)	9 (2–10)	.76	9 (3–10)	10 (4–10)	.51
Use of non-medication pain relief	36/79 (45.6%)	24/64 (37.5%)	.33	39/82 (47.6%)	20/63 (31.8%)	.048
Desire for additional pain medication	8/79 (10.1%)	4/63 (6.3%)	.18	4/81 (5%)	2/63 (3.2%)	.6
Sufficient pain treatment information	60/78 (77%)	51/63 (80.9%)	.56	54/82 (65.9%)	47/63 (74.6%)	.26
Postoperative symptoms^g
Constipation	0 (0–3.5)	0 (0–3)	.71	0 (0–4)	0 (0–1)	.07
Pruritus	0 (0)	0 (0–1)	.25	0 (0–1)	0 (0)	.11
Insomnia	0 (0–2)	0 (0–3)	.64	0 (0–2)	0 (0–1)	.13
Nausea	0 (0)	0 (0–1)	.18	0 (0)	0 (0–1)	.05
Anorexia	0 (0–1.5)	0 (0–1)	.72	0 (0)	0 (0–1)	.22
Other	0 (0)	0 (0)	.98	0 (0)	0 (0)	.51

Values are presented as mean ± standard deviation; median (interquartile range); or number (percentage).

^aSatisfaction with care is on a scale from 1 (least satisfied) to 5 (most satisfied).

^bScores reported on Likert scale where 0 = not satisfied and 10 = very satisfied.

^cScores reported on Likert scale where 0 = never and 10 = always.

^dLikert scale where 0 = never interferes and 10 = always interferes.

^eLikert scale where 0 = no pain relief and 10 = complete pain relief.

^fLikert scale where 0 = no participation and 10 = full participation.

^gScores reported on Likert scale where 0 = not present and 10 = severe symptoms.

Figure 1. Enrollment Flow Diagram. Sums of categories containing duplicates may be higher than the total number of patients because patients may have been part of multiple categories.

Table 1. Demographics by opioid prescription status.

	Opioid prescription (n = 151)			Opioid filling (n = 81)
	Yes (n = 81)	No (n = 70)	p Value	Yes (n = 68)	No (n = 13)	p Value
Age	49.3 ± 13.2	52.3 ± 14.8	.31	50.6 ± 12.9	49.0 ± 13.3	.70
Race
Caucasian	56/81 (69.1%)	45/69 (65.2%)	.15	49/68 (72.1%)	8/13 (61.5%)	.54
African American	20/81 (25%)	21/69 (30.4%)		15/68 (22.1%)	3/13 (30.8%)
Asian	4/81 (3.7%)	0/69 (0%)		3/68 (4.4%)	1/13 (7.7%)
Other	1/81 (1.2%)	3/69 (4.3%)		1/68 (1.5%)	1/13 (7.7%)
Non-Hispanic ethnicity	81/81 (100%)	67/68 (98.5%)	.27	68/68 (100%)	13/13 (100%)	–
Parity	2 (1–2)	2 (0–3)	.73	2 (1–2)	2 (1–3)	.43
Body mass index (BMI)	29 (26–35)	30 (26–35)	.71	29 (26–36)	28 (26–32)	.99
High school or greater education	77/81 (95.1%)	67/69 (97.1%)	.83	65/68 (96%)	12/13 (92.3%)	.40
Preoperative symptoms^a
Beck anxiety inventory^b	3 (0–7)	4 (1–11)	.05	3 (0–8)	5 (1–7)	.92
Constipation	1 (1–1)	1 (1–3)	.04	1 (1–2)	1 (1–1)	.43
Pruritis	1 (1–1)	1 (1–1)	.82	1 (1–1)	1 (1–1)	.34
Nausea	1 (1–1)	1 (1–1)	.73	1 (1–1)	1 (1–1)	.50
Insomnia	2 (1–4)	1 (1–4)	.76	2 (1–4)	2 (1–5)	.89
Anorexia	1 (1–1)	1 (1–1)	.98	1 (1–1)	1 (1–1)	.09
Other	1 (1–9)	1 (1–9)	.99	1 (1–10)	1 (1–7)	.85
Preoperative Surgical Pain Scale^c
Average pain at rest	0 (0–0)	0 (0–1)	.65	0 (0–0)	0 (0–1)	.59
Pain with normal activity	0 (0–2)	0 (0–2)	.84	0 (0–2)	0 (0–3)	.89
Pain with exercise	1 (0–6)	0 (0–3)	.28	1 (0–6)	0 (0–6)	.82
Rating of worst pain	0 (0–1)	0 (0–3)	.5	0 (0–2)	0 (0–1)	.86
Anaesthesia
General anaesthesia	62/79 (78.5%)	51/66 (77.3%)	.51	55/67 (82.1%)	7/12 (58.3%)	.13
Total anaesthesia time (minutes)	83 (67–103)	76 (59–102)	.60	86 (70–104)	64 (53–87)	.03
Procedure classification
Urogynaecologic	30/79 (38%)	20/66 (30.3%)	.33	26/67 (38.8%)	4/12 (33.3%)	.72

Values are presented as mean ± standard deviation; median (interquartile range); or number (percentage).

^aScores reported on Likert scale where 0 = not present and 10 = severe symptoms.

^bA Beck Anxiety Inventory (BAI) score >30 indicates severe anxiety (BAI score can be interpreted as follows: 0–9, no or normal anxiety; 10–18, mild to moderate anxiety; 19–29, moderate to severe anxiety; and 30–63, severe anxiety).

^cScores reported on Likert scale where 0 = no pain sensation and 10 = severe symptoms.

Table 3. Factors examined in logistic regression analysis predicting immediate and delayed satisfaction with pain control.

Postoperative day 1–2Variable	Unadjusted OR (95% CI)	p Value	Adjusted OR (95% CI)^a	p Value
Average pain at rest	0.64 (0.52–0.78)	<.0001	0.72 (0.52–0.99)	.04
Rating of disturbance of average pain	0.99 (0.97–1.007)	0.25	0.99 (0.98–1.02)	.71
Constipation total score	0.84 (0.74–0.95)	0.006	0.87 (0.72–1.04)	.13
Insomnia total score	0.78 (0.67–0.9)	0.001	0.93 (0.74–1.17)	.53
Shared decision making over pain control	1.26 (1.13–1.4)	<.0001	1.16 (1.004–1.34)	.04
Frequency of time spent in severe pain	0.67 (0.56–0.8)	<.0001	0.96 (0.71–1.3)	.8
Pain interference	0.75 (0.64–0.88)	0.0003	0.99 (0.76–1.3)	.92
Percent amount pain relief	1.2 (1.07–1.36)	0.002	1.28 (1.07–1.54)	.008
Adequate provision of pain treatment information	2.7 (1.15–6.5)	0.02	0.95 (0.26–3.55)	.64
Postoperative day 14 Variable	Unadjusted OR (95% CI)	p Value	Adjusted OR (95% CI)^b	p Value
Age (years)	0.99 (0.95–1.02)	0.4	0.99 (0.95–1.05)	.97
Preoperative SPS average pain at rest	0.97 (0.73–1.3)	0.85	0.92 (0.55–1.52)	.74
Preoperative SPS pain with exercise	0.99 (0.98–1.01)	0.42	0.99 (0.98–1.01)	.71
Preoperative SPS rating of worst pain	0.94 (0.77–1.14)	0.53	0.98 (0.71–1.36)	.91
PD14 nausea total	0.67 (0.51–0.9)	0.007	0.71 (0.49–1.02)	.07
PD 14 shared decision making	1.4 (1.21–1.62)	<.0001	1.45 (1.19–1.77)	.0002
PD 14 frequency of severe pain	0.68 (0.54–0.85)	0.0006	0.83 (0.6–1.14)	.25
PD14 percent amount pain relief	1.2 (1.05–1.36)	0.008	1.12 (0.93–1.35)	.23

^aAdjusted ORs with 95% CIs obtained from logistic regression analysis predicting immediate satisfaction with pain control, including all factors listed; desire for additional pain medications was not included in the logistic model due to high correlation (ρ ≥ 0.8) with the listed factors.

^bAdjusted ORs with 95% CIs obtained from logistic regression analysis predicting immediate satisfaction with pain control, including all factors listed; desire for additional pain medications was not included in the logistic model due to high correlation (ρ ≥ 0.8) with the listed factors.