Opioid Prescribing Trends Among Workers' Compensation Patients Undergoing Foot and Ankle Surgery.

Foot & ankle specialist Pub Date : 2024-10-08 DOI:10.1177/19386400241286594

Tyler M Goodwin, Daniel T Miles, Richard D Murray, Andrew W Wilson, Jesse F Doty

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Abstract

Background: The purpose of this study was to evaluate opioid usage and prescribing trends among workers' compensation (WC) patients who underwent foot or ankle operative procedures compared with a control group.

Methods: A retrospective review was conducted for WC and non-WC patients who underwent foot or ankle procedures in a single academic orthopaedic surgery practice. Outcome measures were total morphine milligram equivalents (MME) and number of opioid prescriptions.

Results: A total of 118 patients were identified, including 51 patients in the WC group and 67 in the non-WC group. After index surgery, 67% (34 of 51) of WC patients had 2 or more additional opioid prescriptions compared to 39% (26 of 67) of non-WC patients (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.4-6.7; P = .003). Collectively, there were greater prescriptions of oxycodone MME (P = .002) and hydrocodone MME (P = .07) in the WC cohort.

Conclusions: Workers' compensation patients seem to be prescribed and consume opioids at a higher rate postoperatively. It is important for treating physicians to be aware of these trends, and discussions with patients regarding expected opioid use when planning surgical intervention may be beneficial. Physicians may need to set expectations preoperatively and suggest there are limits on the amount of opioids that can safely be prescribed.

Level of evidence: Level III, Retrospective cohort study, Prognostic.

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接受足踝手术的工伤赔偿患者的阿片类药物处方趋势。

研究背景本研究的目的是评估与对照组相比，接受足部或踝部手术的工伤赔偿（WC）患者中阿片类药物的使用和处方趋势：方法：对在一家学术骨科诊所接受足部或踝部手术的工伤赔偿患者和非工伤赔偿患者进行回顾性研究。衡量结果的指标是吗啡毫克当量（MME）总量和阿片类药物处方数量：共确定了 118 名患者，其中 WC 组 51 人，非 WC 组 67 人。在索引手术后，67% 的 WC 患者（51 例中的 34 例）有 2 个或 2 个以上额外的阿片类药物处方，而非 WC 患者的这一比例为 39%（67 例中的 26 例）（几率比 [OR]，3.1；95% 置信区间 [CI]，1.4-6.7；P = .003）。总体而言，工伤患者队列中的羟考酮MME（P = .002）和氢可酮MME（P = .07）处方量更大：结论：工伤患者的术后阿片类药物处方和使用率似乎更高。主治医生必须意识到这些趋势，在计划手术治疗时与患者讨论阿片类药物的预期用量可能会有所帮助。医生可能需要在术前设定期望值，并建议对可安全处方的阿片类药物用量进行限制：III级，回顾性队列研究，预后性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Foot & ankle specialist

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