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Opioid Overprescribing and Procedure-specific Opioid Consumption Patterns for Plastic and Reconstructive Surgery Patients
Jacqueline Chu, BA; Jeffrey E Janis, MD; Roman J Skoracki, MD; Jenny Barker, MD, PhD
The Ohio State University
2020-01-27
Presenter: Jacqueline Chu
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. This is the original work of the resident and medical student.
Director Name: Gregory Pearson, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Opioid prescribing practices contribute to opioid misuse, dependency, and diversion. There are currently no comprehensive and quantitative evidence-based guidelines that give procedure-specific recommendations regarding opioid prescribing in plastic and reconstructive surgery.
Methods: A retrospective review of 479 plastic surgery patients encompassing 23 different plastic surgery procedure categories was performed. Opioid prescribing patterns and patient-reported opioid usage at 1 and 3 months postoperatively are reported.
Results: Opioid overprescribing was common, averaging an excess of 13 pills per patient across all procedure categories (prescribed vs. consumed, 25.4+/-23.1 vs. 12.1+/-19.7, p=3.0x10^-19), with a total excess of 5,895 pills (30,967 OMEs) for the study's sample. Opioid consumption patterns were determined for all procedure categories and ranged between 4 and 37 pills. A greater proportion of patients who reported a history of preoperative opioid use were still using opioids at the time of their 1-month and 3-month follow-up appointments (62% vs. 9% at 1 month, 31% vs. 1% at 3 months) and were also more likely to report both poorer pain control (7.6+/-2.5 vs. 8.7+/-2.0, p=0.0001) and patient satisfaction (8.9+/-2.3 vs. 9.6+/-0.9, p=0.003). Most patients (83%) did not store opioids in a locked location, and 64% did not dispose of opioids at 1 month.
Conclusions: Opioids are commonly overprescribed by plastic surgery providers. This study determined procedure-specific opioid consumption patterns, which can help providers reduce opioid waste. Additionally, patients do not properly store or dispose of opioids, demonstrating the need for better patient education regarding opioid usage.
