ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2022
The effect of the orthopaedic trauma association's (OTA) pain management guidelines on opioid prescriptions, pain control, and refills in outpatient orthopaedic trauma surgery.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 5 citations in OpenAlex.
- Operative treatment of clavicle fractures results in more opioids prescribed as compared to non-operative management.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Strategies aimed at preventing long-term opioid use in trauma and orthopaedic surgery: a scoping review.BMC musculoskeletal disorders · 2022Article
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Authors and funding
4 authors at 1 institution in 1 country.
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Abstract
purposeTo determine the effect of the Orthopaedic Trauma Association (OTA) pain management guidelines for acute musculoskeletal injuries on opioid prescription sizes, pain control, and refills.
methodsA prospective cohort study was performed at an academic urban level 1 trauma center. 90 patients undergoing outpatient orthopaedic trauma surgery were enrolled before and after the implementation of the OTA pain management guidelines. Adherence to guidelines, pain visual analog scale, and refills were recorded postoperatively and at the 2- and 6-week follow-up visit.
resultsAfter implementation of the guidelines, the number of patients receiving oxycodone decreased from 100 to 27%, with these patients receiving the less potent hydrocodone, instead. The discharge morphine equivalent dose (MED) decreased from a median (interquartile range) of 225 (169-300) to 140 mg (140-210) (p < 0.001). More patients required refills in the guidelines group (42% vs. 20%), resulting in no difference in total MED prescribed (210 (140-280) vs. 225 (169-307)). Adherence to the guidelines occurred in 66% of patients. As-treated analysis of patients with adherent and non-adherent prescriptions found no detectable difference in pain control, number of opioid pills used, or refills at the 2-week and 6-week follow-up.
conclusionsIn the midst of a national opioid crisis, adoption of the OTA's pain management guidelines for orthopaedic trauma surgery warrants further research to determine if it's implementation can reduce the size, variability, and duration of opioid prescriptions. LEVEL OF EVIDENCE: Level II, prospective cohort.
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