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The Impact of Time and State Opioid Legislation on Opioid Prescription Filling in Total Ankle Arthroplasty.

Publication ,  Journal Article
Cunningham, DJ; Wixted, CM; Allen, NB; Hanselman, AE; Adams, SB
Published in: J Foot Ankle Surg
2023

Total ankle arthroplasty (TAA) is an increasingly utilized treatment for ankle arthritis, and opioids are commonly used as part of perioperative pain control. However, many states have enacted opioid-limiting legislation to reduce perioperative opioid prescribing. The aim of this study was to evaluate the impact of time and state legislation on perioperative opioid prescribing in TAA. This study is a retrospective, observational review of 90-day perioperative opioid prescribing in 1,829 patients undergoing TAA throughout the United States using a large insurance database. Initial and cumulative volumes and rates of opioid prescription filling were recorded along with baseline patient and operative characteristics. Dates of state legislation enactment were also recorded. Student t-tests, analysis of variance, and multivariable linear and logistic regression were utilized to analyze the impact of time and state legislation on opioid prescription filling. In the 90-day perioperative time period, initial and cumulative opioid prescription filling in oxycodone 5-mg equivalents has decreased significantly from 2010 (63.8 initial and 163.3 cumulative) to 2019 (41.1 initial and 67.2 cumulative). States with opioid-limiting legislation saw larger and more significant reductions in initial and cumulative opioid prescription filling preact to postact (63.3-50.6 with legislation vs 61.4-51.9 without legislation initial and 146.4-93.3 with legislation vs 125.1-108.6 without legislation cumulative). This study demonstrates that foot and ankle surgeons in states with opioid-limiting legislation have responded by significantly reducing 90-day perioperative opioid prescribing in TAA. These results encourage states without legislation to enact opioid-specific laws to reduce opioid prescribing.

Duke Scholars

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Published In

J Foot Ankle Surg

DOI

EISSN

1542-2224

Publication Date

2023

Volume

62

Issue

1

Start / End Page

156 / 161

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Prescriptions
  • Practice Patterns, Physicians'
  • Pain, Postoperative
  • Orthopedics
  • Humans
  • Arthroplasty, Replacement, Ankle
  • Ankle
  • Analgesics, Opioid
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cunningham, D. J., Wixted, C. M., Allen, N. B., Hanselman, A. E., & Adams, S. B. (2023). The Impact of Time and State Opioid Legislation on Opioid Prescription Filling in Total Ankle Arthroplasty. J Foot Ankle Surg, 62(1), 156–161. https://doi.org/10.1053/j.jfas.2022.06.004
Cunningham, Daniel J., Colleen M. Wixted, Nicholas B. Allen, Andrew E. Hanselman, and Samuel B. Adams. “The Impact of Time and State Opioid Legislation on Opioid Prescription Filling in Total Ankle Arthroplasty.J Foot Ankle Surg 62, no. 1 (2023): 156–61. https://doi.org/10.1053/j.jfas.2022.06.004.
Cunningham DJ, Wixted CM, Allen NB, Hanselman AE, Adams SB. The Impact of Time and State Opioid Legislation on Opioid Prescription Filling in Total Ankle Arthroplasty. J Foot Ankle Surg. 2023;62(1):156–61.
Cunningham, Daniel J., et al. “The Impact of Time and State Opioid Legislation on Opioid Prescription Filling in Total Ankle Arthroplasty.J Foot Ankle Surg, vol. 62, no. 1, 2023, pp. 156–61. Pubmed, doi:10.1053/j.jfas.2022.06.004.
Cunningham DJ, Wixted CM, Allen NB, Hanselman AE, Adams SB. The Impact of Time and State Opioid Legislation on Opioid Prescription Filling in Total Ankle Arthroplasty. J Foot Ankle Surg. 2023;62(1):156–161.
Journal cover image

Published In

J Foot Ankle Surg

DOI

EISSN

1542-2224

Publication Date

2023

Volume

62

Issue

1

Start / End Page

156 / 161

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Prescriptions
  • Practice Patterns, Physicians'
  • Pain, Postoperative
  • Orthopedics
  • Humans
  • Arthroplasty, Replacement, Ankle
  • Ankle
  • Analgesics, Opioid