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

Authors

Clay B Townsend, Thomas Jefferson UniversityFollow
Justin A Ly, Temple University
Ryan Judy, Temple University
Matthew Sherman, Thomas Jefferson UniversityFollow
Nick Elmer, Thomas Jefferson UniversityFollow
Christine Conroy, Thomas Jefferson UniversityFollow
Hesham M Abdelfattah, Temple University
Mark K Solarz, Temple University
Katharine Woozley, Thomas Jefferson UniversityFollow
Asif M Ilyas, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

10-1-2022

Comments

This article is the author’s final published version in Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, Volume 6, Issue 10, October 2022, Pages 1-9.

The published version is available at https://doi.org/10.5435/JAAOSGlobal-D-22-00036. Copyright © Townsend et al.

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.

Recommended Citation

Townsend, Clay B; Ly, Justin A; Judy, Ryan; Sherman, Matthew; Elmer, Nick; Conroy, Christine; Abdelfattah, Hesham M; Solarz, Mark K; Woozley, Katharine; and Ilyas, Asif M, "Larger Perioperative Opioid Prescriptions Lead to Prolonged Opioid Use After Hand and Upper Extremity Surgery: A Multicenter Analysis" (2022). Rothman Institute Faculty Papers. Paper 194.
https://jdc.jefferson.edu/rothman_institute/194

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Language

English