Opioid Prescription Patterns in Hand Surgery: A Medicare Part D Analysis.

Abstract

Background: The opioid crisis continues to be a significant public health concern in the United States, with postoperative prescriptions contributing to the problem. Older adults face increased risks from opioid use, yet prescribing practices for hand surgery in the Medicare population remain understudied. This research aims to elucidate opioid prescription patterns among hand surgeons treating Medicare patients, focusing on national trends, regional variations, and gender differences.

Methods: A retrospective analysis was conducted using data from the Centers for Medicare and Medicaid Services Medicare Part D Prescription Drug Program Prescribers Public Use File for hand surgeons from 2015 to 2019. National trends, regional variations based on US Census Bureau divisions, state-level differences, and gender disparities in opioid prescribing patterns were examined. Key metrics included opioid prescribing rates, proportion of opioid claims to total claims, average prescription duration, and total opioid claims per surgeon.

Results: From 2015 to 2019, a total of 1752 hand surgeons were identified in the Medicare Part D database with a 5-year average of 231 405 opioid claims, comprising 53% of all claims made by hand surgeons. The median opioid prescribing rate decreased from 61.4% in 2015 to 55.3% in 2019. The proportion of opioid claims to total claims fell from 55.4% to 48.27%, and the average prescription duration decreased from 6.3 to 4.67 days. Significant regional and state-level variation was identified. Overall, the South had higher numbers of opioid prescriptions per hand surgeon and prescribed for more days compared with all other regions, but the Midwest and West regions had larger proportions of opioid claims.

Conclusions: Despite an overall decrease in opioid prescribing by hand surgeons for Medicare patients from 2015 to 2019, significant regional and gender-based variations persist. These findings underscore the need for standardized guidelines, improved prescriber education, and better integration of monitoring programs.