Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study

PAINAP Collaborative; Cecilie Siggaard Knoph; James Lucocq; Sivesh Kathir Kamarajah; Søren Schou Olesen; Michael Jones; Jayanta Samanta; Rupjyoti Talukdar; Gabriele Capurso; Enrique de-Madaria; Dhiraj Yadav; Ajith K Siriwardena; John Windsor; Asbjørn Mohr Drewes; Manu Nayar; Sanjay Pandanaboyana

doi:10.1002/ueg2.12641

Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study

PAINAP Collaborative
, Cecilie Siggaard Knoph
, James Lucocq
, Sivesh Kathir Kamarajah
, Søren Schou Olesen
, Michael Jones
, Jayanta Samanta
, Rupjyoti Talukdar
, Gabriele Capurso
, Enrique de-Madaria
, Dhiraj Yadav
, Ajith K Siriwardena
, John Windsor
, Asbjørn Mohr Drewes
, Manu Nayar
, Sanjay Pandanaboyana^*

^*Corresponding author for this work

Applied Health Sciences

Research output: Contribution to journal › Article › peer-review

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Abstract

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.

Original language	English
Journal	United European Gastroenterology Journal
Early online date	14 Aug 2024
DOIs	https://doi.org/10.1002/ueg2.12641
Publication status	E-pub ahead of print - 14 Aug 2024

Bibliographical note

Keywords

abdominal pain
cute necrotic collections
acute pancreatitis
analgesia
opioids
walled-off necrosis

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PAINAP Collaborative, Knoph, C. S., Lucocq, J., Kamarajah, S. K., Olesen, S. S., Jones, M., Samanta, J., Talukdar, R., Capurso, G., de-Madaria, E., Yadav, D., Siriwardena, A. K., Windsor, J., Drewes, A. M., Nayar, M., & Pandanaboyana, S. (2024). Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study. United European Gastroenterology Journal. Advance online publication. https://doi.org/10.1002/ueg2.12641

@article{f01a05bda2af4915875d33564983495e,

title = "Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study",

abstract = "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.",

keywords = "abdominal pain, cute necrotic collections, acute pancreatitis, analgesia, opioids, walled-off necrosis",

author = "\{PAINAP Collaborative\} and Knoph, \{Cecilie Siggaard\} and James Lucocq and Kamarajah, \{Sivesh Kathir\} and Olesen, \{S{\o}ren Schou\} and Michael Jones and Jayanta Samanta and Rupjyoti Talukdar and Gabriele Capurso and Enrique de-Madaria and Dhiraj Yadav and Siriwardena, \{Ajith K\} and John Windsor and Drewes, \{Asbj{\o}rn Mohr\} and Manu Nayar and Sanjay Pandanaboyana",

note = "{\textcopyright} 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.",

year = "2024",

month = aug,

day = "14",

doi = "10.1002/ueg2.12641",

language = "English",

journal = "United European Gastroenterology Journal",

issn = "2050-6406",

publisher = "SAGE Publications",

}

PAINAP Collaborative, Knoph, CS, Lucocq, J, Kamarajah, SK, Olesen, SS, Jones, M, Samanta, J, Talukdar, R, Capurso, G, de-Madaria, E, Yadav, D, Siriwardena, AK, Windsor, J, Drewes, AM, Nayar, M & Pandanaboyana, S 2024, 'Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study', United European Gastroenterology Journal. https://doi.org/10.1002/ueg2.12641

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 - Pandanaboyana, Sanjay

PY - 2024/8/14

Y1 - 2024/8/14

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 - cute necrotic collections

KW - acute pancreatitis

KW - analgesia

KW - opioids

KW - walled-off necrosis

U2 - 10.1002/ueg2.12641

DO - 10.1002/ueg2.12641

M3 - Article

C2 - 39140779

SN - 2050-6406

JO - United European Gastroenterology Journal

JF - United European Gastroenterology Journal

ER -

Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study

Abstract

Bibliographical note

Keywords

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