National Trends in Orthopaedic Pain Management from 2016 to 2020

Area of Science:

• Orthopaedic Surgery
• Pain Management
• Health Services Research

Background:

• Effective pain management is crucial in orthopaedic care for patient recovery and well-being.
• Understanding national and regional pain prescription trends is vital for optimizing patient outcomes.

Purpose of the Study:

• To analyze national and regional pain medication prescription trends among US orthopaedic surgeons.
• To investigate the shift from opioid to nonopioid pain relievers using Medicare claims data and geospatial analysis.

Main Methods:

• Utilized Medicare prescription data (2016-2020) for orthopaedic surgeons, categorizing pain medications (opioids, NSAIDs, etc.).
• Employed geospatial analysis (Geoda, Moran I) and statistical methods (regression, Mann-Whitney U) to identify prescribing patterns and hotspots.
• Incorporated patient demographics and socioeconomic data for comprehensive analysis.

Main Results:

• NSAIDs comprised 57.42% of prescriptions, followed by opioids (28.57%).
• Opioid prescriptions decreased annually by 4.43%, while NSAID prescriptions increased by 3.29%.
• Opioid prescribing hotspots were identified in the West Coast, Northern Midwest, and specific Northeastern states; NSAIDs were more prevalent in the Northeast and South.

Conclusions:

• Orthopaedic surgeons significantly reduced opioid prescribing duration and patient numbers, increasing NSAID use.
• Geospatial analysis revealed distinct regional patterns for opioid and NSAID prescribing.
• Further research using non-Medicare data is recommended to broaden understanding of pain management trends.