2019
DOI: 10.5435/jaaos-d-18-00404
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Oral Opioids Are Overprescribed in the Opiate-Naive Patient Undergoing Total Joint Arthroplasty

Abstract: Introduction: The opioid epidemic in the United States continues to escalate and contribute to potentially preventable deaths. Because many opioid addictions begin with prescription medication, focus on limiting exposure and decreasing availability are essential. This study identifies the average number of opioid pills consumed following primary total knee and hip arthroplasty (TKA and THA) at our institution in opiate-naive patients to provide an estimate of medication required. We hypothesized th… Show more

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Cited by 35 publications
(20 citation statements)
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“…Potential explanations for the model's limited diagnostic performance could reflect the lack of mental and social health measures. Huang and Copp [33] found that surgeon prescribing patterns are variable between surgeons and also within the surgeon's personal practice, although their study does not investigate the association between provider prescribing variability and overall opioid consumption. Conversely, our study finds that prescribing habits among surgeons had no statistical associations with the probability of a second opioid prescription within 30 days of primary TKA.…”
Section: Discussionmentioning
confidence: 97%
“…Potential explanations for the model's limited diagnostic performance could reflect the lack of mental and social health measures. Huang and Copp [33] found that surgeon prescribing patterns are variable between surgeons and also within the surgeon's personal practice, although their study does not investigate the association between provider prescribing variability and overall opioid consumption. Conversely, our study finds that prescribing habits among surgeons had no statistical associations with the probability of a second opioid prescription within 30 days of primary TKA.…”
Section: Discussionmentioning
confidence: 97%
“…Many postoperative complications may be appropriately classified as ORAEs, including nausea and vomiting, ileus, urinary retention, delirium, and respiratory depression, underscoring the interrelatedness of perioperative opioid use and surgical outcomes [6,41]. Despite their toxicities, opioids appear to be overprescribed for postoperative pain [42][43][44][45][46][47]. Available data suggest 42-71% of prescribed opioid pills go unused after surgery, with 73% of postoperative orthopedic patients reporting unused opioid pills at one month post-procedure [42,46].…”
Section: The Burdens Of Perioperative Opioid Overuse and Of Uncontrolmentioning
confidence: 99%
“…When considering reduced opioid quantities at discharge, a common concern among surgeons is an increase in office calls from patients requesting opioid prescription refills. Ample evidence supports that a large portion of opioids prescribed at discharge after surgery go unused, however, and initiatives to limit discharge opioid prescription quantities have successfully reduced opioid exposure without adversely affecting pain management or refill requests [42,[44][45][46]93,473,476,[481][482][483][484][485][486][487][488][489][490]. Maximizing nonopioid therapies and developing patient-specific plans are essential to the success and safety of such practice changes.…”
Section: Discharge Phasementioning
confidence: 99%
“…To provide adequate pain relief and enable early mobilization, opioids are commonly used, both during the hospital stay and after discharge. According to recent studies, 86%-98% of TKA patients in the United States are discharged with strong opioids, mainly oxycodone [12,13]. Surprisingly many studies investigating LOS after fast-track TKA fail to describe which drugs are prescribed at discharge [5,6,14,15].…”
mentioning
confidence: 99%