A Novel Prescription Method Reduces Postoperative Opioid Distribution and Consumption: A Randomized Clinical Trial

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Prescription opioid abuse is a significant public health crisis in the U.S.
• Current opioid prescription practices may inadvertently fuel this epidemic.
• Investigating alternative prescription methods is crucial for mitigating opioid misuse.

Purpose of the Study:

• To evaluate a novel, refill-based opioid prescription strategy.
• To determine its impact on postoperative narcotic distribution and consumption.
• To assess patient-reported outcomes and satisfaction.

Main Methods:

• Randomized controlled trial comparing single vs. divided opioid prescriptions.
• Patients underwent distal radius fracture fixation or thumb carpometacarpal arthroplasty.
• Outcomes measured included dispensed MME, patient consumption, and satisfaction surveys.

Main Results:

• The refill-based group received significantly fewer dispensed opioids (177 vs. 287 MME, P=.0025).
• Patients in the experimental arm reported lower consumption (124 vs. 214 MME, P=.0131).
• A small percentage of experimental patients reported insurance issues, impacting reported pain control.

Conclusions:

• A refill-based prescription method can decrease postoperative opioid use.
• This strategy shows promise in reducing overall narcotic consumption.
• Further research is needed to confirm reproducibility, translatability, and feasibility.