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Inappropriate prescribing of opioids for patients undergoing surgery
Nathan H Varady1, Christopher M Worsham2,3,4, Antonia F Chen5
1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10021.
Summary
Physicians may be inappropriately prescribing opioids to patients' spouses, not the patients themselves. This study found a significant increase in spousal opioid fills on the day of surgery, suggesting misuse.
Area of Science:
- Health Policy
- Clinical Pharmacy
- Public Health
Background:
- The opioid epidemic has led to policies regulating opioid prescriptions.
- Ensuring opioid prescriptions are for intended patients is crucial for policy effectiveness.
- Identifying inappropriate opioid prescribing is challenging.
Purpose of the Study:
- To investigate whether opioid prescriptions are being written for unintended recipients, specifically spouses.
- To examine the rate of opioid prescriptions filled by spouses of patients undergoing outpatient surgery.
Main Methods:
- Analysis of a commercially insured population.
- Studied opioid-naïve couples (450,125).
- Compared spousal opioid prescription fills on the day of surgery (DOS) versus other perioperative days for patients who did not fill their own prescriptions.
Main Results:
- For patients not filling their own opioid prescriptions, spousal fills on DOS were 2.39 per 1,000 surgeries, versus 0.44 on other days (aOR=5.5).
- This increase in spousal fills was not observed when patients filled their own prescriptions.
- Findings suggest intentional, clinically inappropriate opioid prescribing.
Conclusions:
- Opioid prescribing policies may be undermined by prescriptions intended for spouses.
- Evidence suggests clinically inappropriate opioid prescribing practices.
- Further research is needed to address potential opioid diversion and misuse.
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