Scully RE, et al. - This study sought to report the patterns of opioid pain medication prescriptions after common surgical procedures and determine the appropriateness of the prescription as indicated by the rate of refills. Researchers realized that opioid prescriptions after surgery should ideally balance adequate pain management against the duration of treatment. The optimal length of opioid prescriptions in practice lies between the observed median prescription length and the early nadir, or 4 to 9 days for general surgery procedures, 4 to 13 days for women’s health procedures, and 6 to 15 days for musculoskeletal procedures.

Methods

• Researchers used the Department of Defense Military Health System Data Repository to assess opioid-naive individuals 18 to 64 years of age who had undergone 1 of 8 common surgical procedures between January 1, 2005, and September 30, 2014.
• They modeled the adjusted risk of refilling an opioid prescription based on the number of days of initial prescription using a generalized additive model with spline smoothing.

Results

• Within the study time frame, 215,140 individuals (107,588 women and 107,552 men; mean [SD] age, 40.1 [12.8] years) underwent a procedure and received and filled at least 1 prescription for opioid pain medication within 14 days of their index procedure.
• Out of these, 41,107 (19.1%) received at least 1 refill prescription.
• Observations revealed the median prescription lengths of 4 days (interquartile range [IQR], 3-5 days) for appendectomy and cholecystectomy, 5 days (IQR, 3-6 days) for inguinal hernia repair, 4 days (IQR, 3-5 days) for hysterectomy, 5 days (IQR, 3-6 days) for mastectomy, 5 days (IQR, 4-8 days) for anterior cruciate ligament repair and rotator cuff repair, and 7 days (IQR, 5-10 days) for discectomy.
• In the probability of refill, the early nadir was at an initial prescription of 9 days for general surgery procedures (probability of refill, 10.7%), 13 days for women’s health procedures (probability of refill, 16.8%), and 15 days for musculoskeletal procedures (probability of refill, 32.5%).