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Discharge Pain Medications: Do They Affect 6-Month Patient-Reported Outcomes After Operative Treatment of CMC
Mariah N Wegner1, Rebekah M Kleismith2, Stephen A Doxey2
1University of Minnesota Medical School, Minneapolis, USA.
Hand (New York, N.Y.)
|November 25, 2024
Summary
Discharge opioid prescriptions after carpometacarpal (CMC) arthritis surgery did not correlate with patient-reported outcomes (PROs) over six months. Surgeons can confidently limit opioid use without impacting patient recovery.
Area of Science:
- Orthopedic Surgery
- Pain Management
- Patient Outcomes Research
Background:
- Carpometacarpal (CMC) arthritis is a common condition requiring surgical intervention.
- Postoperative pain management, particularly opioid use, is a significant concern after CMC arthroplasty.
- Understanding the relationship between discharge opioid dosage and patient-reported outcomes (PROs) is crucial for optimizing care.
Purpose of the Study:
- To analyze the association between the quantity of opioids prescribed at discharge and patient-reported outcomes (PROs) following operative treatment for CMC arthritis.
- To evaluate PROs over a 6-month period after surgery in relation to initial opioid prescription levels.
Main Methods:
- A prospective study included 172 patients undergoing CMC arthroplasty.
- Patient-reported outcomes were assessed using validated questionnaires (PRWHE, SAE, PROMIS global-10).
- Discharge opioid dosages were quantified in Morphine Milligram Equivalents (MMEs) using CDC guidelines.
Main Results:
- No statistically significant correlation was found between the MMEs prescribed at discharge and changes in PROs at various time points (6 weeks, 3 months, 6 months).
- The majority of patients (70.4%) were female, with an average age of 63.6 years.
- All patients received opioid prescriptions, averaging 191.3 MMEs.
Conclusions:
- The amount of opioids prescribed upon discharge does not appear to influence patient-reported outcomes after CMC arthroplasty.
- Surgeons can consider reducing postoperative opioid prescriptions without compromising patient outcomes.
- This finding supports a more conservative approach to opioid prescribing in this patient population.
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