{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:41:24Z","timestamp":1793104884076,"version":"4.5.0"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241694-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>New persistent opioid use after surgery is contributing to the opioid crisis affecting the US, and interventions to limit postoperative opioid prescriptions have been proposed to mitigate the opioid-related health care burden. Limited information is available regarding the incidence of new persistent use after surgery in other countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241694-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the incidence of new persistent opioid use and to evaluate factors associated with its risk after surgery in Austria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241694-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This retrospective, population-based cohort study used administrative data from the national Austrian social insurance database for adult patients undergoing surgery between January 1, 2016, and December 31, 2021. Exclusion criteria were incomplete exposure or outcome data, early postoperative death, and ongoing opioid use at the time of surgery. Data were analyzed from September 2023 to August 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241694-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>General, gynecological, urological, orthopedic, and cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241694-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary study outcome was the incidence of new persistent opioid use up to 6 months after surgery in the Austrian population; the factors associated with use, including patient factors and surgical procedures, were analyzed. A logistic regression model was used to evaluate the association between the primary outcome and the independent variables after controlling for multicollinearity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241694-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 559\u202f096 patients undergoing 642\u202f857 surgical procedures (median [IQR] age, 60 [48-71] years; 318\u202f391 male patients [49.5%]), new persistent opioid use was documented in 10\u202f810 cases (1.7%) overall, and the rates ranged from 0.3% for appendectomy (130 cases per 40\u202f565 procedures) to 0.7% for abdominal surgery (2198 cases per 335\u202f034 procedures) to 6.8% for spinal surgery (3495 cases per 51\u202f348 procedures). The median (IQR) daily opioid dose in oral morphine equivalents was 7.4 (4.1-14.9) mg. Specific procedures, including spinal surgery (odds ratio [OR], 5.36; 95% CI, 5.04-5.69) and arthroplasty (OR, 1.57; 95% CI, 1.48-1.67), and patient characteristics, such as previous opioid use that was discontinued before surgery (OR, 3.06; 95% CI, 2.93-3.19) and the frequency of previously filled opioid prescriptions (OR, 16.49; 95% CI, 13.63-19.95), were associated with new persistent opioid use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241694-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In Austria, the incidence of new persistent opioid use after surgery is lower than that in North America, but the factors associated with risk are similar. These findings suggest the need for studies comparing pain management strategies, as well as systemic and organizational factors, that contribute to the development of new persistent opioid use after surgery in North American and European health care systems, where less evidence about new persistent opioid use has been available.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.60794","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T11:01:39Z","timestamp":1740049299000},"page":"e2460794","source":"Crossref","is-referenced-by-count":19,"title":["New Persistent Opioid Use After Surgery"],"prefix":"10.1001","volume":"8","author":[{"given":"Razvan","family":"Bologheanu","sequence":"first","affiliation":[{"name":"Division of General Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine, and Pain Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Ludwig Boltzmann Institute for Digital Health and Patient Safety, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aylin","family":"Bilir","sequence":"additional","affiliation":[{"name":"Division of General Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine, and Pain Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Ludwig Boltzmann Institute for Digital Health and Patient Safety, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenz","family":"Kapral","sequence":"additional","affiliation":[{"name":"Division of General Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine, and Pain Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Ludwig Boltzmann Institute for Digital Health and Patient Safety, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Gruber","sequence":"additional","affiliation":[{"name":"The Umbrella Organization of Austrian Social Security Institutions, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Kimberger","sequence":"additional","affiliation":[{"name":"Division of General Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine, and Pain Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Ludwig Boltzmann Institute for Digital Health and Patient Safety, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"issue":"5","key":"zoi241694r1","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1001\/archinternmed.2011.1827","article-title":"Long-term analgesic use after low-risk surgery: a retrospective cohort study.","volume":"172","author":"Alam","year":"2012","journal-title":"Arch Intern Med"},{"issue":"6","key":"zoi241694r2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0504","article-title":"New persistent opioid use after minor and major surgical procedures in US adults.","volume":"152","author":"Brummett","year":"2017","journal-title":"JAMA Surg"},{"issue":"6","key":"zoi241694r3","doi-asserted-by":"publisher","first-page":"1528","DOI":"10.1097\/ALN.0000000000003265","article-title":"Persistent postoperative opioid use: a systematic literature search of definitions and population-based cohort study.","volume":"132","author":"Jivraj","year":"2020","journal-title":"Anesthesiology"},{"issue":"2","key":"zoi241694r4","doi-asserted-by":"publisher","first-page":"e288","DOI":"10.1097\/SLA.0000000000005297","article-title":"New persistent opioid use after surgery: a risk factor for opioid use disorder?","volume":"275","author":"Bicket","year":"2022","journal-title":"Ann Surg"},{"issue":"2","key":"zoi241694r5","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1097\/01.ASM.0001079092.00524.9c","article-title":"New persistent opioid use after surgery.","volume":"84","author":"Karamchandani","year":"2020","journal-title":"ASA Monitor"},{"issue":"5","key":"zoi241694r6","doi-asserted-by":"publisher","first-page":"e577","DOI":"10.1097\/SLA.0000000000004560","article-title":"New persistent opioid use after inguinal hernia repair.","volume":"276","author":"Howard","year":"2022","journal-title":"Ann Surg"},{"issue":"3","key":"zoi241694r7","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1093\/ajhp\/zxab367","article-title":"Persistent postoperative opioid use after total hip or knee arthroplasty: a systematic review and meta-analysis.","volume":"79","author":"Tay","year":"2022","journal-title":"Am J Health Syst Pharm"},{"issue":"5","key":"zoi241694r8","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s11916-021-00943-6","article-title":"Reducing new persistent opioid use after surgery: a review of interventions.","volume":"25","author":"Burns","year":"2021","journal-title":"Curr Pain Headache Rep"},{"issue":"6","key":"zoi241694r9","doi-asserted-by":"publisher","first-page":"760","DOI":"10.18553\/jmcp.2021.20507","article-title":"Increased health care costs associated with new persistent opioid use after major surgery in opioid-naive patients.","volume":"27","author":"Brummett","year":"2021","journal-title":"J Manag Care Spec Pharm"},{"issue":"3","key":"zoi241694r10","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1016\/j.bja.2023.12.002","article-title":"Trajectories of pain and opioid use up to one year after surgery: analysis of a European registry.","volume":"132","author":"Hofer","year":"2024","journal-title":"Br J Anaesth"},{"issue":"5","key":"zoi241694r11","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1016\/j.bja.2024.02.017","article-title":"Postoperative opioid prescribing patterns in Ireland: a retrospective multicentre analysis.","volume":"132","author":"Nolan","year":"2024","journal-title":"Br J Anaesth"},{"issue":"1","key":"zoi241694r12","doi-asserted-by":"publisher","first-page":"7261","DOI":"10.1038\/s41598-022-10788-7","article-title":"Opioid trends in Finland: a register-based nationwide follow-up study.","volume":"12","author":"Keto","year":"2022","journal-title":"Sci Rep"},{"issue":"1","key":"zoi241694r13","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s12893-024-02494-0","article-title":"Incidence and risk factors of new persistent opioid use after surgery and trauma: a systematic review.","volume":"24","author":"Gong","year":"2024","journal-title":"BMC Surg"},{"issue":"5","key":"zoi241694r14","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1111\/j.1365-2125.2008.03283.x","article-title":"Direct-to-consumer information in Europe: the blurred margin between promotion and information.","volume":"66","author":"Velo","year":"2008","journal-title":"Br J Clin Pharmacol"},{"issue":"2","key":"zoi241694r15","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1111\/add.12224","article-title":"Non-medical use of prescription opioids and prescription opioid-related harms: why so markedly higher in North America compared to the rest of the world?","volume":"109","author":"Fischer","year":"2014","journal-title":"Addiction"},{"issue":"3","key":"zoi241694r16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr7103a1","article-title":"CDC clinical practice guideline for prescribing opioids for pain\u2014United States, 2022.","volume":"71","author":"Dowell","year":"2022","journal-title":"MMWR Recomm Rep"},{"issue":"20","key":"zoi241694r17","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.","volume":"310","author":"World Medical Association","year":"2013","journal-title":"JAMA"},{"key":"zoi241694r18","doi-asserted-by":"publisher","first-page":"g1251","DOI":"10.1136\/bmj.g1251","article-title":"Rates and risk factors for prolonged opioid use after major surgery: population based cohort study.","volume":"348","author":"Clarke","year":"2014","journal-title":"BMJ"},{"issue":"9","key":"zoi241694r19","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.10734","article-title":"Opioid prescribing after surgery in the United States, Canada, and Sweden.","volume":"2","author":"Ladha","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"7S","key":"zoi241694r20","doi-asserted-by":"publisher","first-page":"S530","DOI":"10.1016\/j.arth.2022.01.071","article-title":"Prevalence of chronic opioid use in the elderly after hip fracture surgery.","volume":"37","author":"Hereford","year":"2022","journal-title":"J Arthroplasty"},{"issue":"4","key":"zoi241694r21","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1016\/j.athoracsur.2019.06.019","article-title":"Impact of prescribing on new persistent opioid use after cardiothoracic surgery.","volume":"108","author":"Brescia","year":"2019","journal-title":"Ann Thorac Surg"},{"issue":"3","key":"zoi241694r22","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1097\/SLA.0000000000003509","article-title":"Patient factors associated with opioid consumption in the month following major surgery.","volume":"273","author":"Larach","year":"2021","journal-title":"Ann Surg"},{"issue":"8","key":"zoi241694r23","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1136\/rapm-2023-104944","article-title":"Perioperative opioid prescribing and iatrogenic opioid use disorder and overdose: a state-of-the-art narrative review.","volume":"49","author":"Larach","year":"2024","journal-title":"Reg Anesth Pain Med"},{"issue":"6","key":"zoi241694r24","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1016\/j.surg.2021.11.008","article-title":"New persistent opioid use after surgery in patients with a history of remote opioid use.","volume":"171","author":"Agarwal","year":"2022","journal-title":"Surgery"},{"issue":"1","key":"zoi241694r25","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.injury.2017.10.021","article-title":"Polytrauma patients in the Netherlands and the USA: a bi-institutional comparison of processes and outcomes of care.","volume":"49","author":"Dijkink","year":"2018","journal-title":"Injury"},{"issue":"3","key":"zoi241694r26","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1007\/s10754-024-09369-0","article-title":"Analyzing the 20-year declining trend of hospital length-of-stay in European countries with different healthcare systems and reimbursement models.","volume":"24","author":"Golinelli","year":"2024","journal-title":"Int J Health Econ Manag"},{"issue":"11","key":"zoi241694r27","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1001\/jamasurg.2017.0831","article-title":"Prescription opioid analgesics commonly unused after surgery: a systematic review.","volume":"152","author":"Bicket","year":"2017","journal-title":"JAMA Surg"},{"issue":"1","key":"zoi241694r28","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.4234","article-title":"Association of opioid prescribing with opioid consumption after surgery in Michigan.","volume":"154","author":"Howard","year":"2019","journal-title":"JAMA Surg"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2830453\/bologheanu_2025_oi_241694_1739309383.63773.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T11:01:41Z","timestamp":1740049301000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2830453"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,20]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.60794","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,20]]}}}