Journal article
Community opioid dispensing after rib fracture injuries: CODI study
British journal of pain, Vol.19(2), pp.86-99
04/2025
PMID: 39574934
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Abstract
Background: Pain from rib fractures often requires inpatient management with opioid medication. The need for ongoing opioid prescriptions following hospital discharge is poorly understood. Harms associated with long-term opioid use are generally accepted. However, a deeper understanding of current prescribing patterns in this population at-risk is required.
Methods: A retrospective cohort of adult patients hospitalised in Queensland, Australia between 2014 and 2015 with rib fractures (ICD-10-AM: S22.3, S22.4, S22.5), was obtained from the Community Opioid Dispensing after Injury (CODI) study, which includes person-linked hospitalisation, mortality and community opioid dispensing data. Data were extracted 90-days prior to the index-hospitalisation and 720-days after discharge. Factors associated with long-duration (>90 days cumulatively) and increased end-dose were examined using multivariable logistic regressions, odds ratios (OR), and 95% confidence intervals (95% CI).
Results: In total, 4306 patients met the inclusion criteria, and 58.8% had opioids dispensed in the community within 30 days of hospital discharge. 23.6% had long-duration dispensing and 13.7% increased opioid end-doses. Pre-injury opioid use was most associated with long-duration (OR = 12.00, 95% CI 8.99–16.01) and increased end-dose (OR = 9.00, 95% CI 6.75–12.00). Females and older persons had higher odds of long-duration dispensing (Females OR = 1.75, 95% CI 1.38–2.22; Age 65+ OR = 1.86, 95% CI 1.32–2.61). Injury severity and presence of concurrent injuries were not statistically significantly associated with duration or dose (p > .05). Subsequent hospitalisations and death during the follow-up period had statistically significant associations with long-duration and increased end-dose (p < .001).
Conclusion: Opiate prescribing following rib fractures is prolonged in older, and female patients, beyond the traditionally reported recovery time frames requiring analgesia. Previous opioid use (without dependence) is associated with long-duration opioid use and increased end-dose in rib fracture patients. These results support the need for a collaborative health system approach and individualised strategies for high-risk patients with rib fractures to reduce long-term opiate use.
Level of Evidence
Level III, Prognostic/Epidemiological.
Details
- Title
- Community opioid dispensing after rib fracture injuries: CODI study
- Creators
- Frances Williamson - The University of QueenslandMelanie Proper - Royal Brisbane and Women's HospitalRania Shibl - University of the Sunshine CoastSusanna Cramb - Queensland University of TechnologyVictoria McCreanor - Queensland University of TechnologyJacelle Warren - Royal Brisbane and Women's HospitalCate Cameron - Royal Brisbane and Women's Hospital
- Publication Details
- British journal of pain, Vol.19(2), pp.86-99
- Publisher
- SAGE Publications
- Number of pages
- 14
- Grant note
- This study was supported by a Royal Brisbane and Women’s Hospital Foundation Grant.
- Identifiers
- 991013351039902368
- Copyright
- © 2025, Sage Publications.
- Academic Unit
- Faculty of Science and Engineering
- Language
- English
- Resource Type
- Journal article