<< Back to the abstract archive
Opioid Prescribing Practices in Plastic Surgery: A Juxtaposition of Attendings and Trainees
Walter J. Joseph MD, Ian Chow MD, Nicholas Cuccolo BS, Emily H. Beers MD
UPMC Department of Plastic Surgery
2018-02-14
Presenter: Walter J. Joseph MD
Affidavit:
Walter J. Joseph
Director Name: Vu T. Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
PURPOSE: Opioid prescribing practices among surgeons has recently been under heavy scrutiny. There is a dearth of data in this arena, specifically pertaining to Plastic Surgery. As such, we sought to examine prescribing practices among Plastic Surgery attendings and residents.
METHODS: A voluntary survey was distributed to all ACGME-accredited plastic surgery residency programs. Demographic characteristics, opioid prescribing practices, and self-rated ability level pertaining to opioid management and patient interactions were elicited. Summary statistics, regressions, and odds were generated.
RESULTS: Of 78 responders, 59% were male and 39.7% female. 29.5% attendings, 26.9% senior residents, 29.5% junior residents, and 14.1% interns. Interns prescribe oxycodone significantly more than any other group, while attendings seemed to utilize combination medications (i.e. hydrocodone/acetaminophen) more frequently (p<0.03). Interns prescribe significantly fewer pills relative to attendings (p<0.05). Junior residents were 4.49x more likely and senior residents 3.65x more likely than attendings to prescribe additional opioids to avoid phone calls and follow-up visits from patients (p=0.012 and 0.029, respectively). Rated ability (1-10) in managing patients requesting additional opioid medications showed that interns and senior residents were significantly less comfortable than attendings (median ratings 4 and 5, respectively; p<0.02).
CONCLUSION: We have shown that knowledge deficits do exist among trainees and that trainees are significantly less comfortable than their attending counterparts with opioid prescribing and patient management. Therefore, the implementation of more thorough post-operative pain management education in residency may be a cogent strategy in mitigating the opioid crisis.
