Managing an epidemic within a pandemic: orthopedic opioid prescribing trends during COVID-19.

Autor: Turcotte JJ; Luminis Health Anne Arundel Medical Center, Department of Orthopedics, 2000 Medical Parkway, Suite 503, Annapolis, MD, 21401, USA. jturcotte@luminishealth.org., Brennan JC; Luminis Health Anne Arundel Medical Center, Department of Orthopedics, 2000 Medical Parkway, Suite 503, Annapolis, MD, 21401, USA., Johnson AH; Luminis Health Anne Arundel Medical Center, Department of Orthopedics, 2000 Medical Parkway, Suite 503, Annapolis, MD, 21401, USA., King PJ; Luminis Health Anne Arundel Medical Center, Department of Orthopedics, 2000 Medical Parkway, Suite 503, Annapolis, MD, 21401, USA., MacDonald JH; Luminis Health Anne Arundel Medical Center, Department of Orthopedics, 2000 Medical Parkway, Suite 503, Annapolis, MD, 21401, USA.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2024 Jun; Vol. 144 (6), pp. 2473-2479. Date of Electronic Publication: 2024 Apr 25.
DOI: 10.1007/s00402-024-05329-y
Abstrakt: Introduction: In response to the opioid epidemic, a multitude of policy and clinical-guideline based interventions were launched to combat physician overprescribing. However, the sudden rise of the Covid-19 pandemic disrupted all aspects of healthcare delivery. The purpose of this study was to evaluate how opioid prescribing patterns changed during the Covid-19 pandemic within a large multispecialty orthopedic practice.
Materials and Methods: A retrospective review of 1,048,559 patient encounters from January 1, 2015 to December 31, 2022 at a single orthopedic practice was performed. Primary outcomes were the percent of encounters with opioids prescribed and total morphine milligram equivalents (MMEs) per opioid prescription. Differences in outcomes were assessed by calendar year. Encounters were then divided into two groups: pre-Covid (1/1/2019-2/29/2020) and Covid (3/1/2020-12/31/2022). Univariate analyses were used to evaluate differences in diagnoses and outcomes between periods. Multivariate analysis was performed to assess changes in outcomes during Covid after controlling for differences in diagnoses. Statistical significance was assessed at p < 0.05.
Results: The percentage of encounters with opioids prescribed decreased from a high of 4.0% in 2015 to a low of 1.6% in 2021 and 2022 (p < 0.001). MMEs per prescription decreased from 283.6 ± 213.2 in 2015 to a low of 138.6 ± 100.4 in 2019 (p < 0.001). After adjusting for diagnoses, no significant differences in either opioid prescribing rates (post-COVID OR = 0.997, p = 0.893) or MMEs (post-COVID β = 2.726, p = 0.206) were observed between the pre- and post-COVID periods.
Conclusion: During the Covid-19 pandemic opioid prescribing levels remained below historical averages. While continued efforts are needed to minimize opioid overprescribing, it appears that the significant progress made toward this goal was not lost during the pandemic era.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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