The characteristics of opioid use in patients with proximal humerus fractures.

Autor: Meyer LE; Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Dr, Durham, NC, USA. lucy.meyer@duke.edu., O'Donnell JA; Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Dr, Durham, NC, USA., Danilkowicz RM; Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Dr, Durham, NC, USA., Blevins KM; Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Dr, Durham, NC, USA., Helmkamp JK; Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Dr, Durham, NC, USA., Park CN; Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Dr, Durham, NC, USA., Gage MJ; Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Dr, Durham, NC, USA., Anakwenze O; Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Dr, Durham, NC, USA., Klifto CS; Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Dr, Durham, NC, USA.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2023 Aug; Vol. 33 (6), pp. 2405-2409. Date of Electronic Publication: 2022 Dec 02.
DOI: 10.1007/s00590-022-03443-4
Abstrakt: Background: Orthopaedic surgeons prescribe more opioid narcotics than any other surgical specialty. Proximal humerus fractures (PHF) often occur in the high-risk elderly population. The opioid epidemic has led to public policy aimed at reductions in opioid prescription. This study aimed to evaluate the impact that new legislation has had on opioid prescription patterns in patients who sustained proximal humerus fractures.
Methods: A retrospective review of all patients who sustained PHF at a single academic institution from 1/1/2015-12/31/2019 was performed. A total of 762 proximal humerus fractures were identified and final analysis included 383 patients. Collected data included basic demographics and opioid prescriptions obtained through review of the electronic medical record. The North Carolina Strengthen Opioid Misuse Prevention act legislation that went into effect on July 1, 2017.
Results: There was no difference in the number of pre- or postoperative opioid prescriptions provided with the new legislation. Our data showed a significant reduction in MeQs prescribed preoperatively pre-STOP act (188.1 MeQs) and post-STOP act (99.4 MeQs). There was also a significant difference in the amount of postoperative narcotics prescribed in the pre-STOP (972.6 MeQs) and post-STOP act (508.6 MeQs) groups (p < 0.01).
Conclusions: With the enactment of the STOP act in North Carolina, we have seen a significant reduction in the amount of narcotic prescribed after sustaining a proximal humerus fracture preoperatively and postoperatively. This data demonstrates the impact that implementation of state-wide regulatory changes in opioid prescribing policy has had for a common orthopedic condition.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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