Journal article
Community opioid dispensing after rib fracture injuries: CODI study
British Journal of Pain, Vol.19(2), pp.86-99
2025
PMID: 39574934
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
- Authors
- Frances Williamson (Corresponding Author) - Royal Brisbane and Women's HospitalMelanie Proper - Royal Brisbane and Women's HospitalRania Shibl - University of the Sunshine Coast, Queensland, School of Science, Technology and EngineeringSusanna Cramb - Royal Brisbane and Women's HospitalVictoria McCreanor - Queensland University of TechnologyJacelle Warren - Queensland University of TechnologyCate Cameron - Queensland University of Technology
- Publication details
- British Journal of Pain, Vol.19(2), pp.86-99
- Publisher
- Sage Publications Ltd.
- Date published
- 2025
- DOI
- 10.1177/20494637241300264
- ISSN
- 2049-4645
- PMID
- 39574934
- Grant note
- This study was supported by a Royal Brisbane and Women’s Hospital Foundation Grant.
- Organisation Unit
- School of Science, Technology and Engineering
- Language
- English
- Record Identifier
- 991087895702621
- Output Type
- Journal article
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