TY - JOUR
T1 - Global trends in opioid use for pain management in acute pancreatitis
T2 - A multicentre prospective observational study
AU - PAINAP Collaborative
AU - Knoph, Cecilie Siggaard
AU - Lucocq, James
AU - Kamarajah, Sivesh Kathir
AU - Olesen, Søren Schou
AU - Jones, Michael
AU - Samanta, Jayanta
AU - Talukdar, Rupjyoti
AU - Capurso, Gabriele
AU - de-Madaria, Enrique
AU - Yadav, Dhiraj
AU - Siriwardena, Ajith K.
AU - Windsor, John
AU - Drewes, Asbjørn Mohr
AU - Nayar, Manu
AU - Cark, Neil
AU - Pius, Riinu
AU - Houghton, Eduardo
AU - Gimenéz, Mariano
AU - Uribe, Karla
AU - Rodriguez, Florencia
AU - Gundara, Justin
AU - Mackay, Thomas
AU - Phan, Huynh
AU - Lewin, Joel
AU - McElhatton, Claire
AU - Siriwardhane, Mehan
AU - Hodgson, Russell
AU - Malik, Hassan
AU - Ward, Ryan
AU - Young, Kerilee
AU - Bappayya, Shaneel
AU - Loveday, Benjamin
AU - Samra, Jaswinder
AU - Gall, Tamara
AU - Mittal, Anubhav
AU - Chan, Ting Ting
AU - Lo, Vincent Wing ho
AU - Liang, Hui
AU - Wang, Cong
AU - Huang, Wei
AU - Jin, Tao
AU - Wu, Yongzi
AU - Xia, Qing
AU - Georgio, Nikolaou
AU - Koronakis, Nikolaos
AU - Davidsen, Line
AU - Hamed, Emad
AU - Mohamed, Salem
AU - Demetrashvili, Zaza
AU - Abbas, Zaigham
N1 - Publisher Copyright:
© 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.
PY - 2024/10
Y1 - 2024/10
N2 - Background: Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings. Objective: This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients. Methods: This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1-month follow-up. Demographic details, analgesic use, and clinical outcomes were recorded during admission and at discharge. Odds ratios (ORs) for opioid use during admission and at discharge were identified using multivariable regression analyses. Results: Amongst the 1864 patients (52% males, median age 56 (interquartile range, 41–71)) across three different continents, simple analgesics were predominantly used as the primary analgesic (70%). Opioid use during admission was lowest in European centres (67%). Admission in Asian (OR, 2.53 (95% confidence interval (CI), 1.59–4.04), p < 0.001), and Australian (OR, 5.81 (95% CI, 3.19–10.56), p < 0.001) centres was associated with opioid administration during admission compared with European centres. Increased pain severity, longer pre-admission pain duration, organ failure, and longer length of admission increased opioid use during admission. At discharge, Asian (OR, 2.01 (95% CI, 1.40–2.88), p < 0.001) and Australian (OR, 1.91 (95% CI, 1.28–2.85), p = 0.002) centres were associated with opioid prescription compared with European centres. Increased pain severity, longer pre-admission pain duration, acute necrotic collections, and walled-off necrosis also increased the likelihood of opioid prescription at discharge. Conclusion: There are substantial intercontinental differences in opioid use for AP pain. Accordingly, there is a need for international guidelines on pain management in AP.
AB - Background: Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings. Objective: This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients. Methods: This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1-month follow-up. Demographic details, analgesic use, and clinical outcomes were recorded during admission and at discharge. Odds ratios (ORs) for opioid use during admission and at discharge were identified using multivariable regression analyses. Results: Amongst the 1864 patients (52% males, median age 56 (interquartile range, 41–71)) across three different continents, simple analgesics were predominantly used as the primary analgesic (70%). Opioid use during admission was lowest in European centres (67%). Admission in Asian (OR, 2.53 (95% confidence interval (CI), 1.59–4.04), p < 0.001), and Australian (OR, 5.81 (95% CI, 3.19–10.56), p < 0.001) centres was associated with opioid administration during admission compared with European centres. Increased pain severity, longer pre-admission pain duration, organ failure, and longer length of admission increased opioid use during admission. At discharge, Asian (OR, 2.01 (95% CI, 1.40–2.88), p < 0.001) and Australian (OR, 1.91 (95% CI, 1.28–2.85), p = 0.002) centres were associated with opioid prescription compared with European centres. Increased pain severity, longer pre-admission pain duration, acute necrotic collections, and walled-off necrosis also increased the likelihood of opioid prescription at discharge. Conclusion: There are substantial intercontinental differences in opioid use for AP pain. Accordingly, there is a need for international guidelines on pain management in AP.
KW - abdominal pain
KW - acute necrotic collections
KW - acute pancreatitis
KW - analgesia
KW - opioids
KW - walled-off necrosis
UR - https://www.scopus.com/pages/publications/85201535771
U2 - 10.1002/ueg2.12641
DO - 10.1002/ueg2.12641
M3 - Article
C2 - 39140779
AN - SCOPUS:85201535771
SN - 2050-6406
VL - 12
SP - 1114
EP - 1127
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 8
ER -