Incorrect oxycodone use seen in surgical, obstetric wards

A recent study has noted inappropriate prescribing in most patients treated with oxycodone in surgery.

Investigators conducted this retrospective cross-sectional study using a university hospital clinical data warehouse, including patients with at least one administration of oxycodone or morphine in surgery and obstetric wards in 2022. They analysed patients using automatically collected data and a random 100-patient sample through an extensive clinical record review.

“The appropriate use of oxycodone implies four cumulative conditions which are represented by the primary outcomes carried out on the random 100-patient sample,” the investigators said.

Initially, the majority of stays (74 percent) received oxycodone not preceded immediately by morphine. Twenty-one percent had received oxycodone right after morphine, but 44 percent received oxycodone as first strong opioid and 27 percent combined with morphine as first opioid treatment, with <5 percent having any justification.

Of the 1,035 oxycodone administrations recorded, 398 (38.5 percent) were immediate-release forms given for mild pain or without pain assessment. Twenty-eight percent were not combined with other analgesic, while 42 percent were combined with another opioid. Moreover, 60.6 percent were not combined with a laxative.

“Considering the known risk of developing opioid use disorder after a first administration in surgery, important educational effort seems needed,” the investigators said.

“The use of oxycodone, recommended as a second-line treatment after morphine, has risen strongly over the last years,” they noted.