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Larger Perioperative Opioid Prescriptions Lead to Prolonged Opioid Use After Hand and Upper Extremity Surgery: A Multicenter Analysis
Townsend, Clay B. Ly, Justin A. Judy, Ryan Sherman, Matthew B. Elmer, Nick Conroy, Christine Abdelfattah, Hesham M. Solarz, Mark K. Woozley, Katharine Ilyas, Asif M.
Townsend, Clay B.
Ly, Justin A.
Judy, Ryan
Sherman, Matthew B.
Elmer, Nick
Conroy, Christine
Abdelfattah, Hesham M.
Solarz, Mark K.
Woozley, Katharine
Ilyas, Asif M.
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Journal article
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2022-10-24
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http://dx.doi.org/10.5435/jaaosglobal-d-22-00036
Abstract
Introduction: 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. Methods: 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. Results: 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. Conclusion: 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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Townsend, Clay B. MD; Ly, Justin A. BA; Judy, Ryan MD; Sherman, Matthew B. BS; Elmer, Nick BS; Conroy, Christine MD; Abdelfattah, Hesham M. MD; Solarz, Mark K. MD; Woozley, Katharine MD; Ilyas, Asif M. MD, MBA. Larger Perioperative Opioid Prescriptions Lead to Prolonged Opioid Use After Hand and Upper Extremity Surgery: A Multicenter Analysis. JAAOS: Global Research and Reviews 6(10):e22.00036, October 2022. DOI: 10.5435/JAAOSGlobal-D-22-00036
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Wolters Kluwer
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Journal of the American Academy of Orthopaedic Surgeons: Global Research & Reviews, Vol. 6, No. 10
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