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Opioid Prescribing Trends Following Lumbar Discectomy
Albert L Rancu1, Michael J Gouzoulis, Adam D Winter
1From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.
Opioid prescribing after lumbar diskectomy shows factors influencing use. While the percentage of patients receiving opioids slightly rose, the amount and number of prescriptions decreased significantly over a decade.
Area of Science:
- Neurosurgery
- Pain Management
- Health Services Research
Background:
- Lumbar diskectomy is a common surgical procedure.
- Opioid prescriptions are frequently given post-surgery.
- Concerns exist regarding opioid adverse effects and abuse, prompting investigation into prescribing patterns.
Purpose of the Study:
- To investigate opioid prescribing patterns within 90 days following lumbar diskectomy.
- To identify predictors associated with receiving opioid prescriptions and excess morphine milligram equivalents (MMEs).
- To analyze trends in opioid prescribing over time.
Main Methods:
- Retrospective analysis of 271,631 patients undergoing single-level lumbar laminotomy/diskectomy (2011-2021).
- Exclusion criteria applied to ensure data integrity and focus.
- Multivariable regression and linear regression analyses used to assess predictors and temporal trends.
Main Results:
- Opioids were prescribed to 72.1% of patients.
- Opioid prescription was associated with younger age, female sex, higher comorbidity index, and geographic region.
- Median MMEs prescribed decreased from 428.9 in 2011 to 225.0 in 2021.
- Mean number of prescriptions filled decreased from 3.3 to 2.3.
Conclusions:
- Clinical and nonclinical factors influence opioid prescribing and MME amounts post-lumbar diskectomy.
- A significant decrease in MMEs and number of prescriptions filled over the years is encouraging.
- Reduced prescription refills suggest improved patient outcomes and decreased reliance on opioids.
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