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Patterns of Initial Opioid Prescribing to Opioid-Naive Patients.

Publication ,  Journal Article
Larach, DB; Waljee, JF; Hu, H-M; Lee, JS; Nalliah, R; Englesbe, MJ; Brummett, CM
Published in: Ann Surg
February 2020

OBJECTIVE: To determine the proportion of initial opioid prescriptions for opioid-naive patients prescribed by surgeons, dentists, and emergency physicians. We hypothesized that the percentage of such prescriptions grew as scrutiny of primary care and pain medicine opioid prescribing increased and guidelines were developed. SUMMARY OF BACKGROUND DATA: Data regarding the types of care for which opioid-naive patients are provided initial opioid prescriptions are limited. METHODS: A retrospective cross-sectional study using a nationwide insurance claims dataset to study US adults aged 18 to 64 years. Our primary outcome was a change in opioid prescription share for opioid-naive patients undergoing surgical, emergency, and dental care from 2010 to 2016; we also examined the type and amounts of opioid filled. RESULTS: From 87,941,718 analyzed lives, we identified 16,292,018 opioid prescriptions filled by opioid-naive patients. The proportion of prescriptions for patients receiving surgery, emergency, and dental care increased by 15.8% from 2010 to 2016 (P < 0.001), with the greatest increases related to surgical (18.1%) and dental (67.8%) prescribing. In 2016, surgery patients filled 22.0% of initial prescriptions, emergency medicine patients 13.0%, and dental patients 4.2%. Surgical patients' mean total oral morphine equivalents per prescription increased from 240 mg (SD 509) in 2010 to 403 mg (SD 1369) in 2016 (P < 0.001). Over the study period, surgical patients received the highest proportion of potent opioids (90.2% received hydrocodone or oxycodone). CONCLUSIONS: Initial opioid prescribing attributable to surgical and dental care is increasing relative to primary and chronic pain care. Evidence-based guideline development for surgical and dental prescribing is warranted in order to curb iatrogenic opioid morbidity and mortality.

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

February 2020

Volume

271

Issue

2

Start / End Page

290 / 295

Location

United States

Related Subject Headings

  • United States
  • Surgery
  • Surgeons
  • Retrospective Studies
  • Practice Patterns, Physicians'
  • Practice Patterns, Dentists'
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Larach, D. B., Waljee, J. F., Hu, H.-M., Lee, J. S., Nalliah, R., Englesbe, M. J., & Brummett, C. M. (2020). Patterns of Initial Opioid Prescribing to Opioid-Naive Patients. Ann Surg, 271(2), 290–295. https://doi.org/10.1097/SLA.0000000000002969
Larach, Daniel B., Jennifer F. Waljee, Hsou-Mei Hu, Jay S. Lee, Romesh Nalliah, Michael J. Englesbe, and Chad M. Brummett. “Patterns of Initial Opioid Prescribing to Opioid-Naive Patients.Ann Surg 271, no. 2 (February 2020): 290–95. https://doi.org/10.1097/SLA.0000000000002969.
Larach DB, Waljee JF, Hu H-M, Lee JS, Nalliah R, Englesbe MJ, et al. Patterns of Initial Opioid Prescribing to Opioid-Naive Patients. Ann Surg. 2020 Feb;271(2):290–5.
Larach, Daniel B., et al. “Patterns of Initial Opioid Prescribing to Opioid-Naive Patients.Ann Surg, vol. 271, no. 2, Feb. 2020, pp. 290–95. Pubmed, doi:10.1097/SLA.0000000000002969.
Larach DB, Waljee JF, Hu H-M, Lee JS, Nalliah R, Englesbe MJ, Brummett CM. Patterns of Initial Opioid Prescribing to Opioid-Naive Patients. Ann Surg. 2020 Feb;271(2):290–295.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

February 2020

Volume

271

Issue

2

Start / End Page

290 / 295

Location

United States

Related Subject Headings

  • United States
  • Surgery
  • Surgeons
  • Retrospective Studies
  • Practice Patterns, Physicians'
  • Practice Patterns, Dentists'
  • Middle Aged
  • Male
  • Humans
  • Female