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Preoperative and Postoperative Opioid Prescription Rates in the Total Hip Replacement Surgical Patient.

Publication ,  Journal Article
Schmidt, S; Shrian-Chang, K; Silva, S; Goode, V; Horn, M; Cary, MP
Published in: Orthop Nurs
November 2021

The United States is facing an opioid epidemic that has only worsened with the COVID-19 pandemic. There is little evidence regarding patterns of opioid use among patients with total hip replacement (THR). Although the Centers for Disease Control and Prevention has put forward guidelines for prescribing opioids, it does not include guidance specifically for THR patients suffering from presurgical and postsurgical pain. The purpose of this study was to (1) compare presurgical and postsurgical opioid rates, (2) compare presurgical and postsurgical morphine milligram equivalents (MME), and (3) determine whether having a presurgical opioid prescription predicts the receipt of postsurgical opioid prescriptions among patients undergoing THR surgery. Retrospective cohort analysis of 4,405 patients undergoing THR at a major academic medical center in the United States from April 30, 2015, to April 30, 2018, was done. Patient characteristics, opioid rates, and average MME/day/person were described. Logistic regression was used to determine whether presurgical opioid prescription and opioid risk level predicted postsurgical opioid prescribing. Median age was 64 years (range = 18-85 years); patients were primarily Caucasian/White (78.8%) and female (54.7%). Opioid prescription rates in this sample for the 12-month presurgical and postsurgical periods were 66.1% and 95.6%, respectively. Oxycodone was the most common opioid prescribed in both periods. Among those prescribed an opioid, moderate/high risk for overdose and/or death was 6.3% presurgery and 19.8% postsurgery. Patients with a comorbidity were two times more likely to receive an opioid prescription in the postsurgical period. The median average MME/day/person was 26.5 (range = 0.3-180.0) for patients with an opioid prescribed during the presurgery period and 40.4 (range = 1.5-270.0) during the postsurgery period. Opioid use, regardless of strength, in the presurgical period as well as having one or more comorbidities predicted opioid use in the postsurgical period.

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Published In

Orthop Nurs

DOI

EISSN

1542-538X

Publication Date

November 2021

Volume

40

Issue

6

Start / End Page

366 / 374

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • SARS-CoV-2
  • Retrospective Studies
  • Prescriptions
  • Practice Patterns, Physicians'
  • Pandemics
  • Pain, Postoperative
  • Nursing
  • Middle Aged
 

Citation

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Chicago
ICMJE
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Schmidt, S., Shrian-Chang, K., Silva, S., Goode, V., Horn, M., & Cary, M. P. (2021). Preoperative and Postoperative Opioid Prescription Rates in the Total Hip Replacement Surgical Patient. Orthop Nurs, 40(6), 366–374. https://doi.org/10.1097/NOR.0000000000000808
Schmidt, Shawna, Kuang Shrian-Chang, Susan Silva, Victoria Goode, Maggie Horn, and Michael P. Cary. “Preoperative and Postoperative Opioid Prescription Rates in the Total Hip Replacement Surgical Patient.Orthop Nurs 40, no. 6 (November 2021): 366–74. https://doi.org/10.1097/NOR.0000000000000808.
Schmidt S, Shrian-Chang K, Silva S, Goode V, Horn M, Cary MP. Preoperative and Postoperative Opioid Prescription Rates in the Total Hip Replacement Surgical Patient. Orthop Nurs. 2021 Nov;40(6):366–74.
Schmidt, Shawna, et al. “Preoperative and Postoperative Opioid Prescription Rates in the Total Hip Replacement Surgical Patient.Orthop Nurs, vol. 40, no. 6, Nov. 2021, pp. 366–74. Pubmed, doi:10.1097/NOR.0000000000000808.
Schmidt S, Shrian-Chang K, Silva S, Goode V, Horn M, Cary MP. Preoperative and Postoperative Opioid Prescription Rates in the Total Hip Replacement Surgical Patient. Orthop Nurs. 2021 Nov;40(6):366–374.

Published In

Orthop Nurs

DOI

EISSN

1542-538X

Publication Date

November 2021

Volume

40

Issue

6

Start / End Page

366 / 374

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • SARS-CoV-2
  • Retrospective Studies
  • Prescriptions
  • Practice Patterns, Physicians'
  • Pandemics
  • Pain, Postoperative
  • Nursing
  • Middle Aged