Orthopedic Surgeon Decision-Making Processes for Postsurgical Opioid Prescribing

Area of Science:

• Pain Management
• Public Health
• Medical Education

Background:

• Acute and chronic pain pose significant challenges within the Department of Defense, exacerbated by the opioid crisis.
• Leftover opioid prescriptions after orthopedic surgery highlight the need for effective risk mitigation strategies.

Purpose of the Study:

• To evaluate factors influencing opioid prescribing decisions among orthopedic surgery providers.
• To identify potential areas for improving opioid risk mitigation in orthopedic care.

Main Methods:

• A quality improvement project involving an anonymous online survey of orthopedic surgery providers.
• Survey assessed opioid prescribing education, influencing factors, safety practices, and views on safety initiatives.

Main Results:

• Provider prescribing decisions were most influenced by patients' acute postsurgical pain, standardized dosing, and prescription histories.
• Limited patient education on leftover opioid disposal was noted; electronic health record data access was a barrier.
• Providers expressed openness to proposed opioid safety initiatives.

Conclusions:

• Key areas for improvement include provider training, enhanced patient education, and better use of opioid tracking databases.
• Developing standardized opioid dosing recommendations for common orthopedic surgeries is recommended.
• Future initiatives should focus on tailored development and evaluation of opioid safety efforts.