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Larger Perioperative Opioid Prescriptions Lead to Prolonged Opioid Use After Hand and Upper Extremity Surgery: A Multicenter Analysis
Journal article   Open access   Peer reviewed

Larger Perioperative Opioid Prescriptions Lead to Prolonged Opioid Use After Hand and Upper Extremity Surgery: A Multicenter Analysis

Clay B Townsend, Justin A Ly, Ryan Judy, Matthew B Sherman, Nick Elmer, Christine Conroy, Hesham M Abdelfattah, Mark K Solarz, Katharine Woozley and Asif M Ilyas
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, v 6(10), D-22-00036
01 Oct 2022
DOI: https://doi.org/10.5435/JAAOSGlobal-D-22-00036
PMID: 36734644
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.5435/JAAOSGlobal-D-22-00036View
Published, Version of Record (VoR) Open

Abstract

Analgesics, Opioid - therapeutic use Drug Prescriptions Hand - surgery Humans Opioid-Related Disorders - drug therapy Opioid-Related Disorders - epidemiology Opioid-Related Disorders - prevention & control Pain, Postoperative - drug therapy Retrospective Studies
The opioid epidemic remains an ongoing public health crisis. The purpose of this study was to investigate whether surgeons' prescribing patterns of the initial postoperative opioid prescription predispose patients to prolonged opioid use after upper extremity surgery. This multicenter retrospective study was done at three academic institutions. Patients who underwent carpal tunnel release, basal joint arthroplasty, and distal radius fracture open reduction and internal fixation over a 1.5-year period were included. Opioid prescription data were obtained from the Pennsylvania Prescription Drug Monitoring Program website. Postoperatively, 30.1% of the patients (191/634) filled ≥1 additional opioid prescription, and 14.0% (89/634) experienced prolonged opioid use 3 to 6 months postoperatively. Patients who filled an additional prescription postoperatively were initially prescribed significantly more pills (P = 0.001), a significantly longer duration prescription (P = 0.009), and a significantly larger prescription in total milligram morphine equivalents (P = 0.002) than patients who did not fill additional prescriptions. Patients who had prolonged opioid use were prescribed a significantly longer duration prescription (P = 0.026) than those without prolonged use. Larger and longer duration of initial opioid prescriptions predisposed patients to continued postoperative opioid use. These findings emphasize the importance of safe and evidence-based prescribing practices to prevent the detrimental effects of opioid use after orthopaedic surgery.

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5 citations in Web of Science
5 citations in Scopus

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
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