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Plastic Surgeons and Opioid Prescription Trends in the Medicare Population
Kelsey Isbester, BS, Joseph Younis, BS, Konrad Knusel, MS, Corinne Wee, MD, Anand Kumar, MD
University Hospitals: Cleveland Medical Center
2019-01-30
Presenter: Kelsey Isbester
Affidavit:
This study was done entirely by the medical students using a publicly available database. It is the unique work of the students with the help of a resident as well.
Director Name: Anand Kumar
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction: The current opioid epidemic in the United States has demonstrated the harmful effects associated with prescription opioids. For any surgeon, it can be difficult to balance these risks with adequate acute post-operative pain control. As new guidelines and educational efforts develop in an attempt to mitigate these risks, it is important to consider prescriber characteristics in order to properly tailor these endeavors.
Methods: This was a cross-sectional study using 2016 Medicare Provider Utilization and Payment data. Opioid claims made by plastic surgeons were pulled from Medicare Part D data along with details of the claims and characteristics of the prescribing surgeons. Characteristics of plastic surgeons in the top 5% of prescribers were compared to plastic surgeons in the bottom 95%.
Results: There were 2,707 plastic surgeons included from the Medicare Part D database. The surgeons in the top 5% of prescribers had an average of 192 opioid claims compared to 37 in the lower prescribing cohort. Geographic location, gender of prescriber, and number of years in practice all had a significant influence on whether a prescriber was in the top 5%. Additionally, prescribers in the top 5% prescribed longer durations of opioids than those in the 95% group (7 vs. 4 days).
Conclusion: Our study suggests that opioid prescribing patterns follow certain trends related to prescriber characteristics, such as geographic location. Knowledge and recognition of these trends will be helpful in targeting opioid prescriber reform within plastic surgery.
