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National opioid prescription decline across outpatient specialty surgeries: A claims database study
Surya A Veerabagu1, Shannon T Nugent2, Zhi Geng3
1Department of Dermatology, University of New Mexico, Albuquerque, New Mexico.
Background:
The Centers for Disease Control and Prevention encourages physicians to limit unnecessary opioid prescriptions.
Objective:
The proportion of patients from 2009 to 2022 who filled an opioid prescription within 1 week after the same-day, outpatient procedures.
Methods:
Patients aged 18 years and older from Optum Clinformatics Data Mart who underwent one of the following: reduction mammoplasty (plastic surgery), Mohs micrographic surgery (dermatologic surgery), endoscopic sinus surgery (otorhinolaryngology), arthroscopic shoulder surgery (orthopedic surgery), strabismus surgery (ophthalmology), and vasectomy (urology).
Results:
The rate of filled opioid prescriptions for all surgeries increased from 42.8% in 2009 (29,854/69,781) to a peak of 43.1% (26,897/62,348) in 2010. Opioid fill rates decreased annually thereafter to 15.9% in 2022 (9784/61,420). Opioid fill rate average annual percent change was statistically significant across all surgeries (P < .001). The annual percent change for opioid fill rates significantly declined from 2012 to 2017 (annual percent change-5.4, P < .001). The rate of decline more than doubled from 2017 to 2022 (annual percent change-12.9, P < .001).
Limitations:
Clinformatics Data Mart is representative of the U.S. population; however, it may not be generalizable to noncommercially insured patients.
Conclusion:
There has been a decrease in opioid prescriptions after same-day outpatient procedures across multiple surgical subspecialties, demonstrating improved opioid stewardship.
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