{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:27:12Z","timestamp":1791581232279,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["1R01DA042299\u201001A1"],"award-info":[{"award-number":["1R01DA042299\u201001A1"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["1R01DA042299\u201001A1"],"award-info":[{"award-number":["1R01DA042299\u201001A1"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012665","name":"ICES","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012665","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Opioids are commonly prescribed for acute pain after surgery. However, it is unclear whether these prescriptions are usually modified to account for patient age and, in particular, opioid\u2010related risks among older adults. We therefore sought to describe postoperative opioid prescriptions filled by opioid\u2010na\u00efve adults undergoing four common surgical procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study used individually linked surgery and prescription opioid dispensing data from Ontario, Canada to create a population\u2010based sample of 135\u2009659 opioid\u2010na\u00efve adults who underwent one of four surgical procedures (laparoscopic cholecystectomy, laparoscopic appendectomy, knee meniscectomy, or breast excision) between 2013 and 2017. Patient age, in years, was categorized as 18 to 64, 65 to 69, 70 to 74, and 75 and over. Postoperative opioid prescriptions were identified as those filled on or within 6\u2009days of surgical discharge date. For those who filled a prescription, we assessed the total morphine milligram equivalent (MME) dose, types of opioids, and any subsequent opioid prescriptions filled within 30\u2009days of surgical discharge date. Results were presented stratified by surgical procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For three of the four surgical procedures we assessed, the proportion of patients who filled a postoperative opioid prescription decreased with age (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 for trend), and there was a small shift in the type of opioid (more codeine or tramadol and less oxycodone; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 for trend). However, the total MME dose of the initial prescription(s) filled showed minimal age\u2010related trends.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The proportion of opioid\u2010na\u00efve patients filling postoperative opioid prescriptions decreases with age. However, postoperative opioid prescription dosage is not typically different in older adults.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4964","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T05:09:12Z","timestamp":1581656952000},"page":"504-509","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Age and postoperative opioid prescriptions: a population\u2010based cohort study of opioid\u2010na\u00efve adults"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6141-9011","authenticated-orcid":false,"given":"Jennifer","family":"Bethell","sequence":"first","affiliation":[{"name":"Sunnybrook Research Institute  Toronto Ontario Canada"},{"name":"ICES Toronto  Ontario Canada"},{"name":"Institute of Health Policy Management and Evaluation, University of Toronto Toronto  Ontario Canada"},{"name":"Toronto Rehabilitation Institute University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Neuman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Perelman School of Medicine University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania"},{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia Pennsylvania"},{"name":"Center for Perioperative Outcomes Research and Transformation University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania"},{"name":"Center for Pharmacoepidemiology Research and Training University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T.","family":"Bateman","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Perioperative, and Pain Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts"},{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea D.","family":"Hill","sequence":"additional","affiliation":[{"name":"Sunnybrook Research Institute  Toronto Ontario Canada"},{"name":"Department of Critical Care Medicine Sunnybrook Health Sciences Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim S.","family":"Ladha","sequence":"additional","affiliation":[{"name":"Institute of Health Policy Management and Evaluation, University of Toronto Toronto  Ontario Canada"},{"name":"Department of Anesthesia St. Michael's Hospital  Toronto Ontario Canada"},{"name":"Department of Anesthesia University of Toronto  Toronto Ontario Canada"},{"name":"Li Ka Shing Knowledge Institute St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duminda N.","family":"Wijeysundera","sequence":"additional","affiliation":[{"name":"ICES Toronto  Ontario Canada"},{"name":"Institute of Health Policy Management and Evaluation, University of Toronto Toronto  Ontario Canada"},{"name":"Department of Anesthesia St. Michael's Hospital  Toronto Ontario Canada"},{"name":"Department of Anesthesia University of Toronto  Toronto Ontario Canada"},{"name":"Li Ka Shing Knowledge Institute St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Wunsch","sequence":"additional","affiliation":[{"name":"Sunnybrook Research Institute  Toronto Ontario Canada"},{"name":"ICES Toronto  Ontario Canada"},{"name":"Institute of Health Policy Management and Evaluation, University of Toronto Toronto  Ontario Canada"},{"name":"Department of Critical Care Medicine Sunnybrook Health Sciences Centre  Toronto Ontario Canada"},{"name":"Department of Anesthesia University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,13]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Moriya A.S.andMiller G.E.Any use and frequent use of opioids among elderly adults in 2015\u20132016 by socioeconomic characteristics. September 2018. Statistical Brief #515. Agency for Healthcare Research and Quality Rockville MD.https:\/\/meps.ahrq.gov\/mepsweb\/data_files\/publications\/st515\/stat515.pdf. Accessed March 13 2019."},{"key":"e_1_2_9_3_1","unstructured":"Canadian Institute for Health Information.Pan\u2010Canadian trends in the prescribing of opioids 2012 to 2016.https:\/\/secure.cihi.ca\/free_products\/pan-canadian-trends-opioid-prescribing-2017-en-web.pdf. Accessed March 13 2019."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6501e1"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S1847"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-012-0047-7"},{"key":"e_1_2_9_7_1","unstructured":"Commonwealth of Pennsylvania and the Pennsylvania Medical Society.Prescribing guidelines for Pennsylvania. Geriatric Pain. Opioid Use and Safe Prescribing.https:\/\/www.health.pa.gov\/topics\/Documents\/Opioids\/OpioidGuidelinesGeriatrics.pdf. Accessed July 31 2019."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.83a.15023"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2011.307"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NPR.0000511772.62176.10"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2013.09.026"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2017.06.010"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001242"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.12.008"},{"key":"e_1_2_9_15_1","unstructured":"MohantyS RosenthalRA RussellMM NeumanMD KoCY EsnaolaNF. Optimal perioperative care of the geriatric patienthttps:\/\/www.facs.org\/-\/media\/files\/quality-programs\/geriatric\/acs-nsqip-geriatric-2016-guidelines.ashx?la=en. Accessed July 5 2019."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181aae87a"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.1827"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1251"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0504"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.04.010"},{"key":"e_1_2_9_21_1","unstructured":"Health care in Ontario.Ontario drug benefit program. Check medication coverage. 2019.https:\/\/www.ontario.ca\/page\/check-medication-coverage\/Accessed January 5 2019."},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.10734"},{"key":"e_1_2_9_23_1","unstructured":"Ontario Ministry of Health and Long\u2010Term Care. Narcotics Monitoring System (NMS) Pharmacy Reference Manual2012.http:\/\/www.health.gov.on.ca\/en\/pro\/programs\/drugs\/resources\/narcotics_manual.pdf. Accessed January 5 2019."},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j5790"},{"key":"e_1_2_9_25_1","unstructured":"Centers for Medicare & Medicaid Services.Opioid oral morphine milligram equivalent (MME) conversion factors.https:\/\/www.cms.gov\/Medicare\/Prescription-Drug-Coverage\/PrescriptionDrugCovContra\/Downloads\/Opioid-Morphine-EQ-Conversion-Factors-Aug-2017.pdf. 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