Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Prevalence and factors related to fast food consumption among Mutah University Students, Jordan

Objective: To identify the prevalence and factors related to fast food consumption among Mutah University students in Jordan. Methods: A cross-sectional study was conducted during the period from January-April, 2019. A sample of 503 students was recruited from different faculties. The participants were interviewed using a structured and a validated questionnaire. Height and weight were measured for the Body Mass Index (BMI) calculation. Statistical analyses were performed using descriptive, t-test and correlational methods. Results: The prevalence of regular fast food (RFF) consumption (³ 2 times/week) was 59.4%. This prevalence was significantly higher among students spending ³ 21 JD/ week (p= 0.020) and those who were not performing physical exercise (p = 0.025).  Significant correlations were found between RFF consumption and fried potato (r=0.374, p < 0.001), processed meat products (r=0.509, p < 0.001), coffee (r=0.122, p=0.006) and candies (r=0.092, p=0.039). No significant relation was found between fast-food consumption and BMI, religion, gender, field of study or living away from family. The most common reason for RFF consumption was shortage of time (38.5%). Lunch time was the most preferred time to consume fast food (70.2%). Interestingly, 32.4% of the students were willing to read the nutrient information and about two-thirds were interested to choose healthy meals if they were available in the menu. Conclusion: The prevalence of fast food consumption is high. RFF consumption is significantly related to lower physical exercise performance and the amount of pocket money. Raising awareness of university students through nutritional education is highly recommended. Continuous..