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Area of Science:

  • Medical Research
  • Surgical Outcomes
  • Pharmacology

Background:

  • Opioid prescribing patterns after surgery vary significantly.
  • Surgeon characteristics are potential drivers of these prescribing differences.
  • Understanding these factors is crucial for optimizing pain management and reducing opioid misuse.

Purpose of the Study:

  • To investigate the association between surgeon experience and the quantity of opioid prescriptions filled post-surgery.
  • To identify specific surgeon characteristics influencing opioid prescription size.
  • To inform strategies for improving opioid stewardship in surgical care.

Main Methods:

  • Analysis of a 20% national sample of Medicare beneficiaries aged 65 and older undergoing 15 common surgical procedures.
  • Utilized a multi-level linear model to assess the relationship between surgeon characteristics and opioid prescription fills within seven days of discharge.
  • Included data from 174,141 patients and 13,828 surgeons.

Main Results:

  • Over half (53.8%) of patients filled an opioid prescription post-discharge.
  • Surgeons with 0-7 years in practice were associated with the largest opioid prescription amounts.
  • Surgeon credentials, surgical procedure type, and geographic region also correlated with prescription size.

Conclusions:

  • Cumulative surgeon experience is a significant factor in post-operative opioid prescribing behavior.
  • Identifying and addressing surgeon-specific prescribing patterns can lead to more effective opioid stewardship programs.
  • Findings support the development of targeted interventions to standardize and optimize opioid use after surgery.