Between April and May 2017, physicians from an online database who regularly prescribe intravenous (IV) medications for
acute postoperative pain completed a 47-question survey on topics such as patient demographics, IV
analgesia preferences, factors that influence prescribing decisions, and the challenges and unmet needs for the treatment of
acute postoperative pain.
RESULTS: Of 501 surveyed physicians, 55% practiced in community hospitals, 60% had been in practice for > 10 years, and 60% were surgeons. The three categories of IV
pain medications most likely to be prescribed to patients with moderate-to-severe
pain immediately after surgery were
morphine,
hydromorphone, or
fentanyl (95.8% of respondents);
COX-2 inhibitors or nonsteroidal anti-inflammatory drugs (73.7%); and
acetaminophen (60.5%). Past clinical experience (81.6%), surgery type (78.2%), and onset of
analgesia (67.1%) were practice-related factors that most determined their medication choice. Key patient-related risk factors, such as avoidance of medication-related adverse events (AEs), each influenced prescription decisions in > 75.0% of physicians.
Nausea and
vomiting were among the most common challenges associated with
postoperative pain management (76.2 and 60.3%, respectively), and avoidance of
analgesic medication-related AEs was among the three most influential patient-related factors that determined prescribing decision (75%). Physicians reported the top unmet need for
acute pain management in patients experiencing moderate-to-severe
postoperative pain was more medications with fewer side effects (i.e.,
nausea,
vomiting, and
respiratory depression; 80.7%).
CONCLUSIONS:
Opioids remain an integral component of multimodal acute
analgesic therapy for
acute postoperative pain in hospitalized patients. The use of all IV
analgesic medications is limited by concerns over AEs, particularly with
opioids and in high-risk patients. There remains a key unmet need for effective
analgesic medications that are associated with a lower risk of AEs.
FUNDING: Trevena, Inc.