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Table 4 Preoperative opioid use definitional parameters

From: Preoperative opioid use is associated with worse patient outcomes after Total joint arthroplasty: a systematic review and meta-analysis

Study Definition of Opioid User Justification Opioid Use Source of Pharmacy Data Included Opioids Preoperative Duration Preoperative Dose (MED)
Zywiel et al. Any documented opioid use (minimum ≥20 mg morphine equivalents per day) for minimum 6 weeks prior to index procedure Chu et al (2006) N/A Prescription records, clinic notes and admission records N/A Minimum 6 weeks 58 mg
Smith et al. At least 1 opioid prescription within 2 years of index surgery N/A 23% Clinical visit notes, anesthesiology reports, discharge notes, prescription history, and medication lists. Oxycodone, hydrocodone, hydromorphone, morphine, tramadol, codeine N/A N/A
Franklin et al. Any documented opioid prescription prior to index procedure N/A 24% Administrative Database Percocet, Vicodin, Darvocet, Tylenol with codeine
‘other’
N/A N/A
Pivec et al. Minimum of 6 weeks of narcotic use (minimum ≥30 mg morphine equivalents per day) prior to index TKA Chu et al (2006) N/A Clinic charts, in-patient hospital medication administration records, prescription documentation, and phone interviews Morphine, codeine, hydrocodone, hydromorphone, methadone, meperidine, oxycodone, propoxyphene, tramadol, transdermal fentanyl Minimum 6 weeks N/A
Nguyen et al. Continuous opioid use for at least 4 weeks prior to index procedure Chu et al (2006) N/A Clinic and referral notes N/A Minimum 4 weeks a Low 34%
Medium 17%
High 15%
Very High 34%
Goesling et al. Patient-reported opioids use prior to index procedure N/A 29% Chart review, confirmed by patient N/A N/A N/A
  Mean b 24%  
  1. Abbreviations
  2. N/A, data not available, MED Morphine equivalent dose
  3. Notes
  4. aClassification of opioid user: Low (< 30 mg), Medium (31–60 mg) High (61 - 120 mg) and Very High (> 121 mg).
  5. bMean calculated by summing number of patients prescribed preoperative opioids (n = 1747) and dividing by total patients (n = 7163).
  6. Chu et al. (2006) – minimum duration and dosage required of morphine required to develop opioid induced hyperalgesia