Bryant Shuey, Fang Zhang, Edward Rosen, Brian Goh, Nicolas K. Trad, J. Wharam, Hefei Wen
{"title":"Massachusetts’ Opioid Limit Law Associated with a Reduction in Post-Operative Opioid Duration Among Orthopedic Patients","authors":"Bryant Shuey, Fang Zhang, Edward Rosen, Brian Goh, Nicolas K. Trad, J. Wharam, Hefei Wen","doi":"10.1093/haschl/qxad068","DOIUrl":null,"url":null,"abstract":"\n Post-operative orthopedic patients are a high-risk group for receiving long-duration, large-dosage opioid prescriptions. Rigorous evaluation of state opioid duration limit laws, enacted throughout the country in response to the opioid overdose epidemic, is lacking among this high-risk group. We took advantage of Massachusetts’ early implementation of a 2016 7-day limit law that occurred before other statewide or plan-wide policies took affect and used commercial insurance claims from 2014-2017 to study its association with post-operative opioid prescriptions greater than 7-days duration among Massachusetts orthopedic patients relative to a New Hampshire control group. Our sample included 14,097 commercially insured opioid-naïve adults aged 18 and older undergoing elective orthopedic procedures. We found that the Massachusetts 7-day limit was associated with an immediate 4.23-percentage point absolute reduction (95% CI 8.12 to 0.33 percentage points) and a 33.27% relative reduction (95% CI 55.36% to 11.19%) in the percentage of initial fills greater than 7-days in the Massachusetts relative to the control group. Seven-day limit laws may be an important state level tool to mitigate longer duration prescribing to high-risk post-operative populations.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health affairs scholar","FirstCategoryId":"0","ListUrlMain":"https://doi.org/10.1093/haschl/qxad068","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Post-operative orthopedic patients are a high-risk group for receiving long-duration, large-dosage opioid prescriptions. Rigorous evaluation of state opioid duration limit laws, enacted throughout the country in response to the opioid overdose epidemic, is lacking among this high-risk group. We took advantage of Massachusetts’ early implementation of a 2016 7-day limit law that occurred before other statewide or plan-wide policies took affect and used commercial insurance claims from 2014-2017 to study its association with post-operative opioid prescriptions greater than 7-days duration among Massachusetts orthopedic patients relative to a New Hampshire control group. Our sample included 14,097 commercially insured opioid-naïve adults aged 18 and older undergoing elective orthopedic procedures. We found that the Massachusetts 7-day limit was associated with an immediate 4.23-percentage point absolute reduction (95% CI 8.12 to 0.33 percentage points) and a 33.27% relative reduction (95% CI 55.36% to 11.19%) in the percentage of initial fills greater than 7-days in the Massachusetts relative to the control group. Seven-day limit laws may be an important state level tool to mitigate longer duration prescribing to high-risk post-operative populations.
骨科术后患者是接受长时间大剂量阿片类药物处方的高危人群。在这一高危群体中,缺乏对全国各地为应对阿片类药物过量流行而颁布的州阿片类药物持续时间限制法律的严格评估。我们利用马萨诸塞州在其他全州或计划范围内的政策生效之前早期实施的2016年7天限制法律,并使用2014-2017年的商业保险索赔来研究其与马萨诸塞州骨科患者中超过7天的术后阿片类药物处方的关系相对于新罕布什尔州对照组。我们的样本包括14,097名商业保险opioid-naïve年龄在18岁及以上的成年人接受选择性整形手术。我们发现,与对照组相比,马萨诸塞州7天的限制与马萨诸塞州超过7天的初始填充百分比的立即绝对减少4.23个百分点(95% CI 8.12至0.33个百分点)和33.27%的相对减少(95% CI 55.36%至11.19%)相关。7天限制法可能是一个重要的州一级工具,以减少对高风险术后人群的长期处方。