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Orthopedic surgeons may prescribe more opioids than needed after surgery
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Results from a new survey revealed that orthopedic providers routinely prescribed more opioids than required by patients who underwent multiple orthopedic surgical procedures.
“The results of this study were eye-opening. Since it was completed, we have launched a number of initiatives at our institutions to standardize opioid prescriptions, promote multimodal pain regimens, and decrease dispensing in an attempt to provide better care for our patients while minimizing the risks associated with opioid medications,” John Thompson, MD, John Hopkins University resident, told Healio.com/Orthopedics.
Investigators sent an electronic survey to 179 orthopedic physicians and mid-level providers at Johns Hopkins Medical Institutions and the University of Maryland Medical System. The survey described six common orthopedic surgical scenarios to determine opioid type and quantity prescribed at discharge, medication disposal instructions, and the use of prescription drug monitoring programs (PDMPs). Overall, 127 (71%) of the providers completed the survey.
Results showed a statistical significance between the quantity of opioids prescribed and the surgical procedure. However, for five of the surgical scenarios, 95% of providers said they would recommend less than 55 oxycodone 5-mg pill equivalents at discharge. Investigators noted an inverse correlation between years of clinical practice and mean number of pill equivalents prescribed. Less than 40% of providers modified how they prescribed when they saw clinically relevant changes in a scenario such as depression and drug abuse. More than 60% of providers did not used PDMPs. Seventy-nine percent of providers did not offer opioid disposal instructions.
“We have now established opioid prescribing guidelines for routine Orthopaedic procedures, resulting in substantially fewer opioids prescribed than noted in the study,” Dawn Laporte, MD, professor of orthopedic surgery at John Hopkins Medicine, told Healio.com/Orthopedics. “We also teach our orthopedic residents principles of responsible opioid prescribing.”– by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.
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Monitto C, et al. J Opioid Manag. 2019;doi:10.5055/jom.2019.0505.
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