Variations in opioid prescribing after total joint arthroplasty: An Observational study

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Postoperative pain management after total hip and knee arthroplasty (THA, TKA) involves opioid prescriptions.
• Variations in opioid prescribing patterns among healthcare providers can impact patient outcomes and contribute to overprescribing.

Purpose of the Study:

• To analyze opioid prescribing patterns for postoperative pain following primary THA and TKA.
• To identify variations in opioid prescriptions based on provider category, patient demographics, and opioid type.

Main Methods:

• Retrospective review of 1774 patients undergoing primary THA or TKA between 2014 and 2019.
• Analysis of patient demographics, operative variables, and opioid prescriptions, including mean morphine milligram equivalent (MME).
• Generalized linear models used to assess associations between patient/prescriber factors and MME.

Main Results:

• Mean MME prescribed was 1591 per patient up to 90 days postoperatively.
• Females and patients aged 65 or younger received higher MMEs compared to males and older patients, respectively.
• Non-orthopedic physicians prescribed higher MMEs than orthopedic surgeons; hydrocodone and oxycodone had higher MMEs than tramadol.

Conclusions:

• Significant variations exist in opioid prescribing for THA/TKA pain based on prescriber and patient characteristics.
• Findings underscore the need for standardized guidelines to optimize pain management and reduce opioid overprescribing.
• Understanding current prescribing habits is crucial for developing effective interventions in surgical settings.