Evidence map›Paper›PMID 34583716›Full record

ArticleSubstance abuse treatment, prevention, and policy2021

Opioid legislation and narcotic filling in total hip arthroplasty: descriptive study of time and state-level trends in the United States.

Daniel J Cunningham, Sean P Ryan, Steven Z George, Brian D Lewis

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Article in Substance abuse treatment, prevention, and policy, 2021. 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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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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2 citing papers in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Daniel J CunninghamDepartment of Orthopaedic Surgery, Duke University Medical Center, 200 Trent Drive, Durham, NC, 27710, USA. Daniel.cunningham@duke.edu.ORCID 0000-0003-4192-4202
Sean P RyanDepartment of Orthopaedic Surgery, Duke University Medical Center, 200 Trent Drive, Durham, NC, 27710, USA.
Steven Z GeorgeDepartment of Orthopaedic Surgery, Duke University Medical Center, 200 Trent Drive, Durham, NC, 27710, USA.
Brian D LewisDepartment of Orthopaedic Surgery, Duke University Medical Center, 200 Trent Drive, Durham, NC, 27710, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe opioid misuse epidemic focused national attention on reducing opioid overprescribing. The purpose of this study is to describe the relationship of time and state-level interventions and opioid filling surrounding total hip arthroplasty (THA) in the United States.

methodsA national database with diverse insurance constituents was queried for first-prescription and cumulative perioperative opioid filling volumes and rates in oxycodone 5-mg equivalents (OE's) in 487,942 patients undergoing primary THA from 30-days pre-operative to 90-days post-operative. Descriptive statistics evaluated pre-legislative and post-legislative opioid filling by state, legislative type, and surgery year.

resultsAt the national level, initial opioid filling volumes have remained largely unchanged (56.2 OE's in 2010 to 51.7 OE's in 2018). Meanwhile, cumulative opioid filling volumes (151.9 OE's in 2010 to 111.7 OE's in 2018) have decreased considerably. Rates of initial opioid prescriptions exceeding 90 OE's were similar in 2010 (6.4%) and 2018 (5.6%). States with legislation targeting duration and volume of opioid prescriptions saw the largest decreases in opioid prescription filling. That is, 75% of states with opioid legislation had large (> 10 oxycodone 5-mg equivalents) decreases in cumulative 90-day opioid filling compared to only 20% of states without opioid legislation having large decreases in cumulative 90-day opioid filling.

conclusionsThis descriptive study demonstrates decreases in perioperative opioid filling for THA. Although this study was descriptive in nature, states enacting opioid-limiting legislation had larger decreases. Although causal relationships could not be inferred from this analysis, the results suggest that states without legislation could improve prescriber compliance with national goals of decreased opioid overprescribing by enacting opioid-limiting legislation. LEVEL OF EVIDENCE: Level III, retrospective prognostic cohort study.

Indexed as

Analgesics, OpioidArthroplasty, Replacement, HipCohort StudiesHumansNarcoticsPostoperative PainPractice Patterns, Physicians'Retrospective StudiesUnited StatesAnalgesics, OpioidNarcoticsOpioidState legislationTotal hip arthroplasty

Identifiers

PMID34583716
PMCPMC8477542

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