Association of request for opioid medications refill after hospital discharge with race in patients with prostate cancer treated with robotic-assisted laparoscopic radical prostatectomy

Shaheen Alanee, MD; Diana Chammout; Mustafa Deebajah, MD; James Peabody; Mani Menon

doi:10.5055/jom.2022.0738

Authors

Shaheen Alanee, MD https://orcid.org/0000-0002-1585-4557
Diana Chammout
Mustafa Deebajah, MD
James Peabody
Mani Menon

DOI:

https://doi.org/10.5055/jom.2022.0738

Keywords:

opioids, request for refill, race, prostate cancer, prostatectomy

Abstract

Background and objective: Request for refills of opioids is one of the indicators of possible misuse. We aimed to investigate racial variations in request for refills of opioids after hospital discharge from robotic-assisted laparoscopic radical prostatectomy (RALP).

Methods: We conducted a retrospective study of a contemporary cohort of patients treated with RALP for prostate cancer and post-operative standardized pain control that employed nonopioid medications. Patients’ request for refills of opioids (within 30 days) after discharge was examined, accounting for race, age, pain control after surgery, alcohol intake, marijuana consumption, pre-existing behavioral health diagnoses, and pre-existing chronic pain disorders using multivariate analysis. p-Value of < 0.05 was considered significant.

Results: We included a total of 282 adult patients in this study. African Americans (AA) patients comprised 24.5 percent of our post-prostatectomy individuals. Of the total cohort, 94.3 percent of patients reported adequate pain control in the hospital after surgery, and only 5.7 percent requested refills of opioid medications after discharge. No racial variations in request of refills were identified. Only pre-existing chronic pain disorders were found to be a significant predictor of requesting an opioid medication refill for pain control after discharge from the hospital.

Conclusions: A combination of minimally invasive surgery and nonopioid heavy pain management leads to low level of post-hospital discharge request for refills of opioid medication in patients treated with RALP across racial groups. Awareness and better control of chronic pain perioperatively are needed to ensure better post-discharge pain control.

Author Biographies

Shaheen Alanee, MD

Attending Physician, Department of Urology, Detroit Medical Center, Detroit, Michigan

Diana Chammout

Department of Urology, Detroit Medical Center, Detroit, Michigan

Mustafa Deebajah, MD

Department of Urology, Henry Ford Health System, Detroit, Michigan

James Peabody

Department of Urology, Henry Ford Health System, Detroit, Michigan

Mani Menon

Department of Urology, Icahn School of Medicine at Mount Sinai, New York City, New York

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