@article{ref1,
title="Discharge prescribing and subsequent opioid use after traumatic musculoskeletal injury",
journal="American journal of managed care",
year="2023",
author="Basilico, Matthew F. and Bhashyam, Abhiram R. and Harrington, Emma K. and Bharel, Monica and McWilliams, J. Michael and Heng, Marilyn",
volume="29",
number="9",
pages="448-453",
abstract="OBJECTIVE: To investigate the effects of discharge opioid supply after surgery for musculoskeletal injury on subsequent opioid use. STUDY DESIGN: Instrumental variables analysis of retrospective administrative data. <br><br>METHODS: Data were acquired on 1039 patients treated operatively for a musculoskeletal injury between 2011 and 2015 at 2 level I trauma centers. State registry data were used to track all postoperative opioid prescription fills. Discharge surgical resident was identified for each patient. We categorized residents in the top one-third of opioid prescribing as high-supply residents and others as low-supply residents, with adjustment for service attending physician and month. The primary outcome was subsequent opioid use, defined as new opioid prescriptions and cumulative prescribed opioid supply 7 to 8 months after injury. <br><br>RESULTS: On average, patients of high-supply residents received an additional 96 morphine milligram equivalents (MME) at discharge (95% CI, 29-163 MME; P < .01), or 16% more, compared with patients of low-supply residents, which is equivalent to an additional 2-day supply at a typical dosage. In the seventh or eighth month after surgery, patients of high-supply residents received a greater total MME volume than patients of low-supply residents (difference, 13.0 MME; 95% CI, 3.1-22.9 MME; P < .01) despite receiving a greater cumulative supply of opioid medications through the sixth month after surgery. <br><br>CONCLUSIONS: After surgery for musculoskeletal injury, patients discharged by residents who prescribe greater supplies of opioid pain medications received higher supplies of opioids 7 to 8 months after surgery than patients discharged by residents who tend to prescribe less. Thus, limiting postoperative supplies of opioid pain medication may help reduce chronic opioid use.<p /> <p>Language: en</p>",
language="en",
issn="1088-0224",
doi="10.37765/ajmc.2023.89424",
url="http://dx.doi.org/10.37765/ajmc.2023.89424"
}