Journal article
A Novel Prescription Method Reduces Postoperative Opioid Distribution and Consumption: A Randomized Clinical Trial
Hand (New York, N.Y.), Vol.18(8), pp.1314-1322
11/2023
DOI: 10.1177/15589447221096709
PMCID: PMC10617470
PMID: 35656851
Abstract
Background: Prescription opioid abuse in the United States has risen substantially over the past 2 decades. Narcotic prescription refill restrictions may paradoxically be contributing to this epidemic. We investigated a novel, refill-based opioid prescription method to determine whether it would alter postoperative narcotic distribution or consumption. Methods: In this randomized controlled trial, patients undergoing internal fixation of distal radius fractures or thumb carpometacarpal joint arthroplasty received either a single prescription for all postoperative narcotics (control arm) or the same amount of pain medication divided into 3 equal prescriptions to be filled as needed (experimental arm). Outcomes included total narcotics dispensed, measured in morphine milligram equivalents (MME) through a prescription monitoring program, patient-reported opioid consumption versus opioid not consumed, and a satisfaction survey. Results: Forty-eight participants were enrolled; 25 were randomized to the control arm and 23 to the experimental arm. At 8 weeks post-op, fewer opioids had been dispensed to the experimental arm (177 ± 94 vs 287 ± 123 MME, P = .0025). At 6-week follow-up, the experimental arm reported lower narcotic consumption (124 ± 105 vs 214 ± 110 MME, P = .0131). Subanalysis of the independent surgeries yielded similar results. Some patients reported insurance issues when filling subsequent prescriptions. Consequently, although 100% of control arm patients reported good pain control, only 82.6% of experimental arm patients said likewise ( P = .0455). Conclusions: This randomized clinical trial demonstrated that patients obtained and consumed fewer narcotics when postoperative opioids were given in a refill-based prescription method. More research is needed to determine whether this opioid distribution method is reproducible, translatable, and feasible.
Details
- Title: Subtitle
- A Novel Prescription Method Reduces Postoperative Opioid Distribution and Consumption: A Randomized Clinical Trial
- Creators
- John M. Yanik - University of Iowa Hospitals and ClinicsNatalie A. Glass - University of IowaLindsey S. Caldwell - University of IowaJoseph A Buckwalter V - University of Iowa Hospitals and Clinics, Iowa City, USATimothy P. Fowler - University of IowaEricka A. Lawler - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Hand (New York, N.Y.), Vol.18(8), pp.1314-1322
- DOI
- 10.1177/15589447221096709
- PMID
- 35656851
- PMCID
- PMC10617470
- NLM abbreviation
- Hand (N Y)
- ISSN
- 1558-9447
- eISSN
- 1558-9455
- Language
- English
- Electronic publication date
- 06/03/2022
- Date published
- 11/2023
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984304716602771
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