Survey Reveals Gaps in Opioid Rx Patterns of Orthopedic Surgeons

The vast majority of orthopedic surgeons recommend prescribing a nine-day supply of around-the-clock oxycodone doses following commonly performed orthopedic surgeries, according to a study published in the May/June issue of the Journal of Opioid Management.

Constance Monitto, M.D., from Johns Hopkins University in Baltimore, and colleagues surveyed 127 orthopedic surgeons using six scenarios to assess prescribing patterns (opioid type and quantity prescribed at discharge), medication disposal instructions, and the use of prescription drug monitoring programs (PDMPs) in the prescription writing process.

The researchers found statistically significant associations between quantity of opioids prescribed and surgical procedure. However, for five of six scenarios, 95 percent of respondents recommended prescribing >55 oxycodone 5-mg pill equivalents (PEs) at discharge. There was an inverse correlation between years of clinical practice and mean number of PEs prescribed. When presented with clinically relevant changes in scenarios (e.g., history of depression or drug abuse), fewer than 40 percent of respondents modified their prescriptions. More than 60 percent of surgeons reported they do not use PDMPs, while 79 percent do not provide opioid disposal instructions. "

Our findings support a need for targeted education to mitigate the role of orthopedic postoperative prescribing practices on the current opioid abuse epidemic," the authors write.

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