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Rates of Opioid Prescriptions Obtained After Mohs Surgery: A Claims Database Analysis From 2009 to 2020

Surya A Veerabagu1, Brian Cheng2, Sonia Wang3

  • 1Tulane University School of Medicine, New Orleans, Louisiana.

JAMA Dermatology
|September 22, 2021
PubMed
Abstract

Insights

Opioid prescriptions after Mohs surgery decreased significantly from 2011 to 2020, indicating a positive response to public health initiatives. Hydrocodone use declined while tramadol prescriptions increased during this period.

Area of Science:

  • Dermatology
  • Public Health
  • Pain Management

Background:

  • Physicians are advised to limit opioid prescriptions to combat the opioid epidemic.
  • Mohs micrographic surgery is a common dermatologic procedure often associated with postsurgical pain management.

Purpose of the Study:

  • To analyze the trends in opioid prescriptions following Mohs micrographic surgery between 2009 and 2020.
  • To understand changes in the types of opioids prescribed after Mohs surgery over time.

Main Methods:

  • A cross-sectional study utilizing the Optum Clinformatics DataMart (Optum CDM) insurance claims database.
  • Inclusion of patients aged 18 years and older who underwent Mohs micrographic surgery from 2009 to 2020.

Main Results:

  • The proportion of patients receiving opioid prescriptions post-Mohs surgery rose from 34.6% in 2009 to 39.6% in 2011, then declined to 11.7% in 2020.
  • Hydrocodone prescriptions decreased by 21.7% from 2011 to 2020, while tramadol prescriptions increased by 26.3% during the study period.
  • A total of 358,012 patients were included in the analysis, with a mean age of 69 years.

Conclusions:

  • Post-Mohs surgery opioid prescription rates have declined, reflecting increased awareness and adherence to public health guidelines.
  • The shift in opioid prescribing patterns, with decreased hydrocodone and increased tramadol, warrants further investigation.
  • These findings suggest that dermatologic surgeons and patients are responding to concerns about the opioid epidemic.

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