The Effect of an Educational Program on Opioid Prescription Patterns in Hand Surgery: A Quality Improvement Program

Stanek, Joel; Renslow, Mark A.; Kalliainen, Loree K.

doi:10.1016/j.jhsa.2014.10.054

Cited by 171 publications

(159 citation statements)

References 8 publications

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“…27,28 Similar to our findings, Rodgers et al reported that opioid needs were higher among patients who underwent bony-related procedures, and lower among Medicare beneficiaries. 28 Although this study was conducted within a single center, the authors noted that nearly two-thirds of the pills in a single prescription went unused, which underscores the need for appropriate prescribing practices to prevent excess opioid medications reaching unintended users.…”

Section: Discussionsupporting

confidence: 90%

The Use of Opioid Analgesics following Common Upper Extremity Surgical Procedures

Waljee

Zhong

Hou

et al. 2016

Plastic and Reconstructive Surgery

148

105

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Background The misuse of opioid analgesics is a major public health concern, and guidelines regarding postoperative opioid use are sparse. We examined the use of opioids following outpatient upper extremity procedures. We hypothesized that opioid use varies widely by procedure and patient factors. Methods We studied opioid prescriptions among 296,452 adults ages ≥ 18 years who underwent carpal tunnel release, trigger finger release, cubital tunnel release, and thumb carpometacarpal (CMC) arthroplasty from 2009 to 2013. We analyzed insurance claims drawn using Truven Health MarketScan Commercial Claims and Encounters, which encompasses over 100 health plans in the United States. Using multivariable regression, we compared the receipt of opioids, number of days supplied, indicators of inappropriate prescriptions, and number of refills by patient factors. Results In this cohort, 59% filled a postoperative prescription for opioid medication, and 8.8% patients had an indicator of inappropriate prescribing. The probability of filling an opioid prescription declined linearly with advancing age. In multivariate analysis, patients who had previously received opioids were more likely to fill a postoperative opioid prescription (66% vs. 59%), receive longer prescriptions (24 vs. 5 days), receive refills following surgery (24% vs. 5%), and have at least one indicator of potentially inappropriate prescribing (19% vs 6%). Conclusions Current opioid users are more likely to require postoperative opioid analgesics for routine procedures, and more likely to receive inappropriate prescriptions. More evidence is needed to identify patients who derive the greatest benefit from opioids in order to curb opioids prescriptions when alternative analgesics may be equally effective and available.

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Section: Discussionsupporting

confidence: 90%

The Use of Opioid Analgesics following Common Upper Extremity Surgical Procedures

Waljee

Zhong

Hou

et al. 2016

Plastic and Reconstructive Surgery

148

105

View full text Add to dashboard Cite

show abstract

“…Use of preoperative pain risk assessment cards and coordinated postoperative order sets has been shown to decrease the overall number of narcotics given to patients. 37 The proposed reason for decreased narcotic prescriptions in observed groups using risk assessment cards was that care became standardized for both prescribing surgeons and given operations.…”

Section: Discussionmentioning

confidence: 99%

Management of Acute Postoperative Pain in Hand Surgery: A Systematic Review

Kelley

Shauver

Chung

2015

The Journal of Hand Surgery

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“…Stanek et al showed that a simple educational intervention can change opioid prescribing practices in hand surgeons, 41 demonstrating that there is willingness among surgeons if the appropriate guidance is available. Opioid medications are a necessary part of modern surgical practice, and they can be used safely when appropriate precautions are taken.…”

Section: Recommendationsmentioning

confidence: 99%

Managing Opioid Addiction Risk in Plastic Surgery during the Perioperative Period

Demsey

Carr

Clarke

et al. 2017

Plastic &Amp; Reconstructive Surgery

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Summary Opioid addiction is a public health crisis that affects all areas of medicine. Large numbers of the population across all racial and economic demographics misuse prescription opioids and use illicit opioids. The current understanding is that opioid misuse is a disease that requires treatment, and is not an issue of choice or character. Use of opioid medication is a necessary part of postoperative analgesia, but many physicians are unsure of how to do this safely given the risk of patients developing an opioid misuse disorder. This review gives an update of the current state of the opioid crisis, explains how current surgeons prescribing practices are contributing to it, and gives recommendations on how to use opioid medication safely in the perioperative period.

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The Effect of an Educational Program on Opioid Prescription Patterns in Hand Surgery: A Quality Improvement Program

Cited by 171 publications

References 8 publications

The Use of Opioid Analgesics following Common Upper Extremity Surgical Procedures

The Use of Opioid Analgesics following Common Upper Extremity Surgical Procedures

Management of Acute Postoperative Pain in Hand Surgery: A Systematic Review

Managing Opioid Addiction Risk in Plastic Surgery during the Perioperative Period

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