Patterns of opioid prescribing for an orthopaedic trauma population

Details

• Alternative Title:
  J Orthop Trauma
• Personal Author:
  Ruder, John ; Wally, Meghan K. ; Oliverio, McKell ; Seymour, Rachel B. ; Hsu, Joseph R.
• Description:
  Objectives
  
  To determine opioid prescribing practices to the orthopaedic trauma (OT) population at one level I trauma center.
  
  Design
  
  A retrospective study of discharge prescriptions for adult OT patients. Prescription details, injury burden, and patient demographics were abstracted for patients from initial injury through 2 month follow up.
  
  Setting
  
  A busy level I trauma center.
  
  Patients/Participants
  
  Adult OT patients admitted over a 30-day period (n=110).
  
  Intervention
  
  All discharge and follow-up opioid prescriptions were recorded.
  
  Main Outcome Measurements
  
  Morphine milligram equivalents per day, Number of opioid prescriptions, type/dose of medication prescribed
  
  Results
  
  135 Discharge prescriptions were written for 110 patients with orthopaedic injuries during the review period (Table 1). All patients received opioids at the time of discharge (Table 2). The MMEs prescribed at the time of discharge was 114 mg (54–300 mg) for a mean of 7.21 days (2–36.7 days). While patients with pre-injury risk factors were prescribed discharge opioids for a similar duration (7.00 days, versus 7.30 days, p=0.81) than those without risk factors, they were prescribed significantly more MMEs than those without (130 versus 108, p<.05), and were more likely to receive ER/LA opioids than those without (42.11% versus 21.98%).
  
  Conclusions
  
  Pain management after orthopaedic trauma continues to be opioid-centric despite involving a population at risk. Further focus on prescriber and patient education, risk evaluation with mitigation, guideline development, and comprehensive pain management strategies are warranted in the orthopaedic trauma population.
  
  
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over Analgesics, Opioid Drug Prescriptions Drug Utilization Drug Utilization Review Female Humans Male Medical Overuse Middle Aged Orthopedic Procedures Pain, Postoperative Practice Patterns, Physicians' Prevalence Young Adult

  More +
• Source:
  J Orthop Trauma. 31(6):e179-e185.
• Pubmed ID:
  28538457
• Pubmed Central ID:
  PMC5445932
• Document Type:
  Journal Article
• Funding:
  U01 CE002520/CE/NCIPC CDC HHS/United States
• Place as Subject:
  North Carolina
• Volume:
  31
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5b17d9c77fbe73dbc6a6973944b7ddd7447386d0713a4b61b9630ee9a2df5e9d
• Download URL:
  https://stacks.cdc.gov/view/cdc/45910/cdc_45910_DS1.pdf
• File Type:
  [PDF - 88.73 KB ]