Recent Opioid Prescribing Trends at the Rothman Orthopaedic Institute

BROCK BAKEWELL, MPH

ASIF ILYAS, MD, MBA, FACS

SUMMARY POINTS

• Rothman physicians have reduced the number of opioid prescriptions from 2015 to 2019 by 18.9%

• Rothman physicians have reduced the number of opioid pills per prescriptions from 2015 to 2019 by 51.3%

• Rothman physicians have reduced the amount of MME per prescriptions from 2015 to 2019 by 59.4%

• Rothman physicians have reduced the amount of MME per surgery from 2015 to 2019 by 64.2%

INTRODUCTION

The Opioid Crisis is an ongoing problem in America with opioid-related deaths having become the leading cause of accidental deaths among young Americans. The US Department of Health & Human Services reports that approximately 130 Americans die daily from opioid-related causes. The cause of the Opioid Crisis is multi-factorial, but among the most common causes is misuse and abuse of prescription opioids.

Orthopaedic Surgeons in particular are among the highest prescriber of opioids. Specifically, Orthopaedic Surgeons are the third highest prescriber of opioids in terms of the number of opioids prescriptions written per prescriber on average.1 As such, the Orthopaedic Surgeons at the Rothman Orthopaedic Institute have embraced evidenced-based pain management focusing on decreasing and limiting reliance on opioids.

ANALYSIS

To determine the impact of the Rothman Orthopaedic Institute’s embrace of evidenced-based pain management strategies focused on decreasing reliance on opioids for post-operative pain, a review was performed. This analysis examined Rothman physicians' opioid prescribing habits during the last six months of 2015 and compared them to the last six months of 2019. Physicians were included if they were utilizing the same electronic medical record system in both 2015 and 2019. Representative physicians were selected from various surgical sub-specialties.

Between 2015 versus 2019, the number of opioids prescribed at the Rothman Orthopaedic Institute decreased from 56 to 20 Morphine Milligram Equivalent (MME) per surgery, resulting in a decrease of 59.4%. Similarly, the number of opioid pills prescribed between 2015 and 2019 decreased by 51.3%. In 2015 and 2019, the number of opioids prescribed across specialties varied, showing spine and joint surgeons prescribing the most opioids while hand surgeons prescribed the least (Table 1). Overall, total prescription rates decreased by 18.9%.

REFRENCES

1. Levy B, Paulozzi L, Mack KA, Jones CM. Trends in Opioid Analgesic-Prescribing Rates by Specialty, U.S., 2007-2012. Am J Prev Med. 2015;49(3):409-413.