From the Rothman Institute Orthopaedics (Mr. Raneses, Dr. Freedman, and Dr. Aland), Thomas Jefferson University, Atrium Health, Charlotte, NC (Dr. Secrist), the University of Toledo Medical Center, Toledo, OH (Dr. Sohn), and the Town Center Orthopaedic Associates, Reston, VA (Dr. Fleeter).
J Am Acad Orthop Surg. 2019 Feb 15;27(4):e166-e172. doi: 10.5435/JAAOS-D-16-00750.
Opioids are widely used after orthopaedic procedures. Nonmedical opioid use is a growing public health issue.
An anonymous online survey was distributed by e-mail to the orthopaedic societies of all 50 states and several large private practices to assess practicing orthopaedic surgeons' opioid prescribing practices.
A total of 555 orthopaedic surgeons practicing in 37 states responded. The most commonly prescribed opioid for both teenagers and adults was hydrocodone/acetaminophen. Of note, 42.3% reported that a patient they have prescribed opioids for developed an opioid dependency, whereas 35.3% do not believe that opioid use is a problem in their practice. Of note, 30.3% reported prescribing refills, and factors significantly associated with increased prescribing of refills included a greater number of years in practice (P < 0.001) and practicing in a suburban rather than an urban or rural environment (P = 0.03).
Orthopaedic surgeons rarely prescribe any refills, tend to prescribe less opioids to teenagers than adults, and prescribe fairly uniformly for patients who are treated nonsurgically or undergo minor or arthroscopic surgery. They exhibit considerable variation in prescribing for fractures and major procedures.
阿片类药物在骨科手术后被广泛使用。非医疗性阿片类药物的使用是一个日益严重的公共卫生问题。
通过电子邮件向所有 50 个州的骨科协会和几家大型私人诊所分发了匿名在线调查,以评估执业骨科医生的阿片类药物处方实践。
共有 555 名在 37 个州执业的骨科医生做出了回应。青少年和成年人最常开的阿片类药物是氢可酮/对乙酰氨基酚。值得注意的是,42.3%的人报告说,他们给开了阿片类药物的患者出现了阿片类药物依赖,而 35.3%的人不认为他们的实践中存在阿片类药物使用问题。值得注意的是,30.3%的人报告开了阿片类药物的续方,与增加开阿片类药物续方显著相关的因素包括行医年限更长(P<0.001)和在郊区而不是城市或农村行医(P=0.03)。
骨科医生很少开任何续方,给青少年开的阿片类药物往往比给成年人开的少,而且对接受非手术治疗或接受小手术或关节镜手术的患者开的处方相当统一。他们在开骨折和大手术的处方方面存在很大差异。