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July 30, 2020
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Opioid prescription rates increased in patients undergoing THA, TKA from 2014 to 2017

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Despite the implementation of policies restricting opioid overprescription, recently published study results showed a “substantial increase” in the percentages of patients receiving opioids after total hip and knee arthroplasties.

From 2014 to 2017, researchers from The University of Texas Medical Branch, Galveston examined opioid prescription rates and pain control in 86,058 patients who underwent THA (mean age, 64.48 years) and 150,573 patients who underwent TKA (mean age, 65.99 years).

The researchers subsequently analyzed the patients for opioids prescribed and total morphine mg equivalent dose for up to 60 days after discharge, according to the study.

They calculated level of pain using a mean pain score observed at discharge, from seven to 14, 15 to 21, 22 to 29, 30 to 44 and 45 to 60 days after discharge.

Despite a decrease in morphine mg equivalent dose, the researchers found that opioid prescription rates saw a “substantial increase” during the study period.

“The proportion of patients who received an opioid prescription within 60 days of discharge increased from 81.9% to 91.5% after TKA and 82.0% to 89.7% after THA,” they wrote in the study. “The mean of total morphine milligram equivalent prescribed within 60 days increased for both groups from 2014 to 2015, stayed stable from 2015 to 2016, and decreased from 2016 to 2017,” the researchers wrote.

“These findings suggest that the outcomes of policies aimed at curbing postoperative opioid overprescribing after THA and TKA may be limited,” they added. “Our findings underscore the need to monitor effectiveness of policies in the real-world setting, given the substantial amount of resources devoted to their implementations,” the researchers concluded.