Evidence map›Paper›PMID 37004553›Full record

Observational studyArchives of orthopaedic and trauma surgery2023

Post-total joint arthroplasty opioid prescribing practices vary widely and are not associated with opioid refill: an observational cohort study.

Krista B Highland, Hillary A Sowa, Germaine F Herrera, Austin G Bell, Kyle L Cyr, Alexander G Velosky, Jeanne C Patzkowski, Trevor Kanter, Michael S Patzkowski

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Krista B HighlandDepartment of Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. krista.highland@usuhs.edu.ORCID http://orcid.org/0000-0003-3815-2571
Hillary A SowaSchool of Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Germaine F HerreraDepartment of Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Austin G BellDepartment of Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Kyle L CyrDepartment of Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Alexander G VeloskyDepartment of Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Jeanne C PatzkowskiDepartment of Orthopaedic Surgery, Brooke Army Medical Center, 3551 Roger Brooke Drive, TX, 78234-6200, Fort Sam Houston, USA.
Trevor KanterEmory University, 201 Dowman Drive, Atlanta, GA, 30322, USA.
Michael S PatzkowskiDepartment of Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Uniformed Services University of the Health Sciences · USBrooke Army Medical Center · USHenry M. Jackson Foundation · USEisenhower Medical Center · USEmory University · US

Funding

Uniformed Services University of the Health Sciences HU00011920042
6 · The paper itself

Abstract

introductionOptimized health system approaches to improving guideline-congruent care require evaluation of multilevel factors associated with prescribing practices and outcomes after total knee and hip arthroplasty. MATERIALS AND

methodsElectronic health data from patients who underwent a total knee or hip arthroplasty between January 2016-January 2020 in the Military Health System Data were retrospectively analyzed. A generalized linear mixed-effects model (GLMM) examined the relationship between fixed covariates, random effects, and the primary outcome (30-day opioid prescription refill).

resultsIn the sample (N = 9151, 65% knee, 35% hip), the median discharge morphine equivalent dose was 660 mg [450, 892] and varied across hospitals and several factors (e.g., joint, race and ethnicity, mental and chronic pain conditions, etc.). Probability of an opioid refill was higher in patients who underwent total knee arthroplasty, were white, had a chronic pain or mental health condition, had a lower age, and received a presurgical opioid prescription (all p < 0.01). Sex assigned in the medical record, hospital duration, discharge non-opioid prescription receipt, discharge morphine equivalent dose, and receipt of an opioid-only discharge prescription were not significantly associated with opioid refill.

conclusionIn the present study, several patient-, care-, and hospital-level factors were associated with an increased probability of an opioid prescription refill within 30 days after arthroplasty. Future work is needed to identify optimal approaches to reduce unwarranted and inequitable healthcare variation within a patient-centered framework.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeChronic PainAnalgesics, OpioidCohort StudiesHumansMorphinePostoperative PainPractice Patterns, Physicians'Retrospective StudiesAnalgesics, OpioidMorphineHealth services researchOpioidsPain managementTotal hip arthroplastyTotal knee arthroplasty

Identifiers

PMID37004553
OpenAlexW4362507311

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.