{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T12:28:59Z","timestamp":1774700939231,"version":"3.50.1"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:sec id=\"ab-ooi250080-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Persistent opioid use after otolaryngology\u2013head and neck surgery (OHNS) is concerning. However, evidence-based guidelines for managing opioid refill prescriptions within 90 days after discharge, a critical period for the transition from acute to persistent opioid use, are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250080-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify perioperative risk factors associated with opioid refills at 1 to 30, 31 to 60, and 61 to 90 days after OHNS procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250080-6\">\n                    <jats:title>Design, Setting, Participants<\/jats:title>\n                    <jats:p>This cohort study used opioid prescription data from a large academic medical center. The study included adult patients, regardless of opioid-naive status, who underwent inpatient OHNS procedures and were discharged between January 2017 and December 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250080-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>OHNS with a postoperative hospital stay of at least 1 day.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250080-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcomes were opioid refills at 1 to 30, 31 to 60, and 61 to 90 days after discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250080-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 4132 adult patients, the median (IQR) age was 62 (49-72) years, and 1870 (45.3%) were female. From 2017 to 2023, despite a substantial reduction in the total oral morphine equivalents (OME) of discharge opioid prescriptions after OHNS procedures, opioid refill rates remained unchanged. In multiple logistic regression analysis, underprescription (adjusted odds ratio [AOR], 1.60 [95% CI, 1.24-2.06]) and overprescription (AOR, 1.58 [95% CI, 1.29-1.95]) of discharge opioid daily doses (defined as \u22657.5 OME lower or higher than the patient\u2019s inpatient opioid consumption during the last 24 hours before discharge), compared with a matched prescription, were associated with increased odds of refills within 30 days of discharge. Overprescription was also associated with increased odds of refills at 31 to 60 days (AOR, 1.34 [95% CI, 1.03-1.75]). Other factors associated with increased odds of refills at various time points included preoperative use of opioids, benzodiazepines, and cannabis; higher postsurgical pain levels; receiving a prior refill; and receiving an opioid prescription despite not using any inpatient opioids during the last 24 hours of hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250080-10\">\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>This cohort study identified independent perioperative risk factors for opioid refills after inpatient OHNS procedures and proposes an evidence-based strategy to reduce refill risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoto.2025.4576","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T16:00:38Z","timestamp":1765468838000},"page":"199","source":"Crossref","is-referenced-by-count":1,"title":["Independent Factors 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