Factors Associated With Patients’ Perceived Importance of Opioid Prescribing Policies in an Orthopedic Hand Surgery Practice

Bargon, Claudia A.; Zale, Emily L.; Magidson, Jessica F.; Chen, Neal C.; Ring, David; Vranceanu, Ana‐Maria

doi:10.1016/j.jhsa.2018.06.118

Cited by 14 publications

(15 citation statements)

References 33 publications

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“…Studies assessing patients’ perceptions of opioids in other fields have found similar results, whereby patients report that they feel opioids are a valid option for their pain management. 1 , 7 , 14 , 19 Despite such perceptions, other studies have found associations between postoperative opioid use with lower satisfaction, poorer physical function, and greater pain intensity. 1 , 4 , 10 , 11 , 12 This explicitly expresses the need for preoperative patient education about the risk and benefits of opioid use.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 7 , 14 , 19 Despite such perceptions, other studies have found associations between postoperative opioid use with lower satisfaction, poorer physical function, and greater pain intensity. 1 , 4 , 10 , 11 , 12 This explicitly expresses the need for preoperative patient education about the risk and benefits of opioid use.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative patient education is proven to have a significant effect on the duration of opioid consumption postoperatively. 1 , 15 , 16 , 17 , 23 However, prior studies have suggested that opioid medication does not improve how patients rate their postoperative healthcare experience. 6 This raises 2 important questions: how do patients perceive opioid medications and what can orthopedic surgeons do to adequately control pain and improve patient experience, while also decreasing the use of opioid prescriptions?…”

mentioning

confidence: 99%

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What do patients think about opioids? a survey of patient perceptions regarding pain control after shoulder surgery

Sabesan¹,

Dawoud²,

Chatha³

et al. 2021

JSES International

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Background There is an increasing need to understand what barriers are present to reduce opioid consumption in orthopedic practice. The purpose of this study was to better understand patient perceptions and understanding of opioid use after shoulder surgery. Methods Eighty-five patients who underwent shoulder surgery anonymously completed a 27-question survey adapted from the Maryland Public Opinion Survey on Opioids with additional demographics. The patients were asked about pain expectations after surgery, use of and access to opioids, opioid perceptions, and information provided regarding safe use, storage, and disposal of opioids. Results When asked about receiving information regarding opioids, only 36% of the patients reported having a conversation with their physician. When asked about appropriate use, 10% agree it is permissible to take more than the recommended dosage of prescription narcotics if they are feeling more pain than usual and 8.5% of the patients reported taking an opioid to get high multiple times in the past year. Furthermore, a majority agreed that opioids may lead to other substance abuse with 76% reporting the risk of harm to be great, and only 55% believing that opioid abuse may lead to overdose or death. Conclusions Surgeons need to be aware that most patients expect to have significant pain after shoulder surgery and expect to be given necessary and continued amounts of opioids. This highlights the need for better counseling and innovative nonopioid pain management protocols. At the institutional level, more effort needs to be made on providing adequate education and disposal mechanisms to help reduce diversion and misuse.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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What do patients think about opioids? a survey of patient perceptions regarding pain control after shoulder surgery

Sabesan¹,

Dawoud²,

Chatha³

et al. 2021

JSES International

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“…[31][32][33][34] Provider-patient communication should aim to normalize expectations for pain following surgery and correct misconceptions that patients may have about the efficacy and safety of opioids for pain management. 35,36 Furthermore, encouragement to address psychosocial factors can be a part of a more comprehensive non-pharmacologic pain management strategy following shoulder surgery. 37 In light of our findings, a careful evaluation of medical comorbidities, psychosocial distress, and current substance use, as well as the surgeons' motivation for prescribing opioids should be considered.…”

Section: Discussionmentioning

confidence: 99%

Preoperative opioid use in patients undergoing shoulder surgery

et al. 2019

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Background Opioids are commonly used to manage pain from acute injury or chronic degenerative diseases. The objective of this study was to assess the prevalence of preoperative opioid use in patients undergoing shoulder surgery and the clinical factors associated with preoperative opioid use. Methods This was an analytical cross-sectional study of 175 patients undergoing shoulder surgery at an urban hospital from June 2015 to June 2017. Multivariable regression models were used to determine independent associations. Results Fifty-three patients reported preoperative opioid use, which was significantly associated with primary procedure performed (Current Procedural Terminology [CPT]), higher body mass index (BMI), unemployment, lower income, smoking, higher American Society of Anesthesiologists score, greater number of previous surgeries, higher comorbidity burden, and decreased expectations to exercise and do recreational activities (p < 0.05). Preoperative opioid use was independently associated with worse scores on the: Numeric Pain Scale, ASES, IPAQ, and PROMIS domains of Physical Function, Pain Interference, and Social Satisfaction (p < 0.05). Conclusion More than one in four patients reported preoperative opioid use. Several health measures, including worse pain, function, and social satisfaction were independently associated with preoperative opioid use. These findings suggest that orthopaedic surgeons need to identify patients using opioids preoperatively in order to effectively establish and execute a plan for pain management, which may include weaning off opioids prior to surgery, managing psychological distress, and optimizing coping strategies. Level of Evidence: III.

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“…20 Ongoing studies indicate that most patients will respond favorably to the opioid education process and wish to minimize opioid prescription in the perioperative setting. 25…”

Section: Patient Education Programs That Lead To Decreased Opioid Conmentioning

confidence: 99%

What’s New in the Battle Against the Opioid Crisis in Hand Surgery: A Review

Seigerman

Lutsky

Kwok

et al. 2019

Journal of Hand Surgery Global Online

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The opioid epidemic is the subject of much debate and research within all medical fields. Notable work has been done in hand surgery. The purpose of this article is to review the recent literature as it pertains to opioid use in hand surgery. The scope of the current problem is identified and mitigating strategies are described. More studies are necessary to evaluate the efficacy of these strategies.

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Factors Associated With Patients’ Perceived Importance of Opioid Prescribing Policies in an Orthopedic Hand Surgery Practice

Cited by 14 publications

References 33 publications

What do patients think about opioids? a survey of patient perceptions regarding pain control after shoulder surgery

What do patients think about opioids? a survey of patient perceptions regarding pain control after shoulder surgery

Preoperative opioid use in patients undergoing shoulder surgery

What’s New in the Battle Against the Opioid Crisis in Hand Surgery: A Review

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