Post-operative opioid pain management patterns for patients who receive hip surgery.

Journal Article (Journal Article)

BACKGROUND: Identifying optimal, post-operative opioid management strategies is a priority of health providers and government agencies. At present, there are no studies we are aware of that have formally investigated opioid prescribing patterns for post-operative non-arthroplasty orthopedic conditions such as femoroacetabular impingement, nor has any study investigated the influence of opioid prescription patterns on health care costs and utilization. We aimed to investigate a subgrouping scheme associated with post-operative opioid prescription strategies and measure the subgroups' direct and indirect health care utilization and costs in individuals undergoing non-arthroplasty orthopedic hip surgery. METHODS: The study was an observational cohort of routine military clinical practices. We used cluster analysis to characterize pre-operative (12 months) and post-operative (24 months) opioid prescription patterns. Linear mixed effects modeling (with statistical controls for baseline status) identified opioid prescription pattern subgroups and identified subgroup differences in health care utilization and costs. RESULTS: Two distinct clusters were identified representing 1) short-duration, high total days' supply (SD-HD), and 2) long-duration, lesser total days' supply (LD-LD) post-operative prescription patterns. Significantly higher costs and health care utilization for both hip-related and non-hip-related variables were consistently identified in the SD-HD group. CONCLUSIONS: Long-term opioid prescription use has been identified as a concern, but our findings demonstrate that LD-LD post-operative opioid management for hip surgery recipients was associated with lower costs and utilization. Whether these management patterns were a reflection of pre-operative health status, impacted pain-related outcomes, or can be replicated in other orthopedic procedures remains a consideration for future studies. TRIAL REGISTRATION: NA.

Full Text

Duke Authors

Cited Authors

  • Cook, CE; Rhon, DI; Lewis, BD; George, SZ

Published Date

  • March 16, 2017

Published In

Volume / Issue

  • 12 / 1

Start / End Page

  • 14 -

PubMed ID

  • 28298221

Pubmed Central ID

  • PMC5353894

Electronic International Standard Serial Number (EISSN)

  • 1747-597X

Digital Object Identifier (DOI)

  • 10.1186/s13011-017-0094-5


  • eng

Conference Location

  • England