State regulation positively impacts opioid prescribing patterns in ankle fracture surgery: A national and state-level analysis.

Journal Article (Journal Article)

BACKGROUND: The impact of time and state regulation on opioid prescribing in orthopedic trauma is not well known. The purpose of this study is to evaluate the impact of time and state-level opioid legislation on 90-day perioperative opioid prescribing in ankle fracture surgery from 2010 to 2019. METHODS: This is a retrospective, cohort study using a national insurance database including commercial insurance, Medicare, Medicaid, and cash pay patients to evaluate 30-day pre-operative to 90-day post-operative opioid prescription filling in 40,286 patients ages 18 and older undergoing Current Procedural Terminology codes 27,766, 27,769, 27,792, 27,814, 27,822, and/or 27,823 between 2010 and 2019 in all 50 United States. The primary study outcome was initial and cumulative perioperative opioid prescription filling and rates of filling and refills over the study timeframe. RESULTS: Mean first prescription volume has not changed dramatically from 2010 (37 oxycodone 5 mg pills) to 2019 (33.3 oxycodone 5 mg pills). However, cumulative prescriptions within the 30PRE-90POST timeframe have decreased considerably from 2010 (128.5 oxycodone 5 mg pills) to 2019 (70.4 oxycodone 5 mg pills), and cumulative prescription filling in years 2018 and 2019 was significantly less than in 2010. Legislation targeting duration or duration and volume had the largest impacts on initial and cumulative opioid prescribing. CONCLUSIONS: In ankle fracture surgery, states with opioid prescribing legislation had larger reductions in perioperative opioid prescribing compared to states without opioid legislation. Legislation targeting duration or duration and volume had the largest impacts on opioid prescribing. LEVEL OF EVIDENCE: Level III, Retrospective prognostic cohort study.

Full Text

Duke Authors

Cited Authors

  • Cunningham, DJ; Blatter, M; Adams, SB; Gage, MJ

Published Date

  • February 2022

Published In

Volume / Issue

  • 53 / 2

Start / End Page

  • 445 - 452

PubMed ID

  • 34836628

Electronic International Standard Serial Number (EISSN)

  • 1879-0267

Digital Object Identifier (DOI)

  • 10.1016/j.injury.2021.11.039

Language

  • eng

Conference Location

  • Netherlands