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High-Risk Prescribing Increases Rates of New Persistent Opioid Use in Total Hip Arthroplasty Patients

Lia D Delaney1, Vidhya Gunaseelan2, Heidi Rieck2

  • 1University of Michigan Medical School, Ann Arbor, MI.

The Journal of Arthroplasty
|May 12, 2020
PubMed
Abstract

Insights

Surgeon prescribing habits significantly impact new persistent opioid use after hip replacement surgery. High-risk prescribing by surgeons increases the likelihood of patients developing long-term opioid dependence.

Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Public Health

Background:

  • The link between surgeon prescribing behaviors and persistent postoperative opioid use remains unclear.
  • This study investigates surgeon prescribing patterns and their association with new persistent opioid use in total hip arthroplasty (THA) patients.

Purpose of the Study:

  • To examine the association between surgeon prescribing practices and new persistent opioid use in patients undergoing total hip arthroplasty (THA).

Main Methods:

  • A retrospective analysis of Medicare claims data from Michigan (2013-2016) was conducted.
  • Opioid-naïve THA patients over 65 years old were included.
  • Surgeons were categorized by prescribing quartiles, and multilevel logistic regression analyzed associations with new persistent opioid use.

Main Results:

  • High-risk prescribing occurred in 66% of encounters.
  • Patients of surgeons with the highest high-risk prescribing rates had significantly higher persistent opioid use (9.7% vs. 4.6%).
  • Larger initial prescription sizes and higher 30-day dosages were associated with increased odds of persistent opioid use.

Conclusions:

  • Surgeon prescribing patterns are a key factor in the development of persistent postoperative opioid use.
  • Strategies to reduce opioid prescribing and promote alternatives are crucial for minimizing persistent opioid use after surgery.
Keywords:
high-risk prescribingopioid prescribingpersistent opioid useprescribing characteristicstotal hip arthroplasty

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