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Persistent Opioid Use and High-Risk Prescribing in Body Contouring Patients.

Publication ,  Journal Article
Bennett, KG; Kelley, BP; Vick, AD; Lee, JS; Gunaseelan, V; Brummett, CM; Waljee, JF
Published in: Plast Reconstr Surg
January 2019

BACKGROUND: Opioid misuse occurs commonly among obese patients and after bariatric surgery. However, the risk of new persistent use following postbariatric body contouring procedures remains unknown. METHODS: The authors examined insurance claims from Clinformatics Data Mart (OptumInsight, Eden Prairie, Minn.) between 2001 and 2015 for opioid-naive patients undergoing five body contouring procedures: abdominoplasty/panniculectomy, breast reduction, mastopexy, brachioplasty, and thighplasty (n = 11,257). Their primary outcomes included both new persistent opioid use, defined as continued prescription fills between 90 and 180 days after surgery, and the prevalence of high-risk prescribing. They used multilevel logistic regression to assess the risk of new persistent use, adjusting for relevant covariates. RESULTS: In this cohort, 6.1 percent of previously opioid-naive patients developed new persistent use, and 12.9 percent were exposed to high-risk prescribing. New persistent use was higher in patients with high-risk prescribing (9.2 percent). New persistent use was highest after thighplasty (17.7 percent; 95 percent CI, 0.03 to 0.33). Increasing Charlson comorbidity indices (OR, 1.11; 95 percent CI, 1.05 to 1.17), mood disorders (OR, 1.27; 95 percent CI, 1.05 to 1.54), anxiety (OR, 1.41; 95 percent CI, 1.16 to 1.73), tobacco use (OR, 1.22; 95 percent CI, 1.00 to 1.49), neck pain (OR, 1.23; 95 percent CI, 1.04 to 1.46), arthritis (OR, 1.30; 95 percent CI, 1.08 to 1.58), and other pain disorders (OR, 1.36; 95 percent CI, 1.16 to 1.60) were independently associated with persistent use. CONCLUSIONS: Similar to other elective procedures, 6 percent of opioid-naive patients developed persistent use, and 12 percent were exposed to high-risk prescribing practices. Plastic surgeons should remain aware of risk factors and offer opioid alternatives. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

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Published In

Plast Reconstr Surg

DOI

EISSN

1529-4242

Publication Date

January 2019

Volume

143

Issue

1

Start / End Page

87 / 96

Location

United States

Related Subject Headings

  • Young Adult
  • Weight Loss
  • United States
  • Treatment Outcome
  • Time
  • Surgery
  • Risk Assessment
  • Retrospective Studies
  • Prevalence
  • Pain, Postoperative
 

Citation

APA
Chicago
ICMJE
MLA
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Bennett, K. G., Kelley, B. P., Vick, A. D., Lee, J. S., Gunaseelan, V., Brummett, C. M., & Waljee, J. F. (2019). Persistent Opioid Use and High-Risk Prescribing in Body Contouring Patients. Plast Reconstr Surg, 143(1), 87–96. https://doi.org/10.1097/PRS.0000000000005084
Bennett, Katelyn G., Brian P. Kelley, Alexis D. Vick, Jay S. Lee, Vidhya Gunaseelan, Chad M. Brummett, and Jennifer F. Waljee. “Persistent Opioid Use and High-Risk Prescribing in Body Contouring Patients.Plast Reconstr Surg 143, no. 1 (January 2019): 87–96. https://doi.org/10.1097/PRS.0000000000005084.
Bennett KG, Kelley BP, Vick AD, Lee JS, Gunaseelan V, Brummett CM, et al. Persistent Opioid Use and High-Risk Prescribing in Body Contouring Patients. Plast Reconstr Surg. 2019 Jan;143(1):87–96.
Bennett, Katelyn G., et al. “Persistent Opioid Use and High-Risk Prescribing in Body Contouring Patients.Plast Reconstr Surg, vol. 143, no. 1, Jan. 2019, pp. 87–96. Pubmed, doi:10.1097/PRS.0000000000005084.
Bennett KG, Kelley BP, Vick AD, Lee JS, Gunaseelan V, Brummett CM, Waljee JF. Persistent Opioid Use and High-Risk Prescribing in Body Contouring Patients. Plast Reconstr Surg. 2019 Jan;143(1):87–96.

Published In

Plast Reconstr Surg

DOI

EISSN

1529-4242

Publication Date

January 2019

Volume

143

Issue

1

Start / End Page

87 / 96

Location

United States

Related Subject Headings

  • Young Adult
  • Weight Loss
  • United States
  • Treatment Outcome
  • Time
  • Surgery
  • Risk Assessment
  • Retrospective Studies
  • Prevalence
  • Pain, Postoperative