Abstract
Objectives:
Opioid pain medication is most commonly prescribed after distal radius fracture fixation, and there is high variability in the quantity and duration prescribed. Comorbidities including substance use and depression have been associated with higher consumption habits and increased sizes of postoperative opioid prescriptions has been previously linked to increasing risk of chronic opioid use and opioid use disorder. The purpose of this study was to investigate opioid prescription patterns after distal radius fracture fixation and identify patient specific risk factors for increased postoperative opioid consumption.
Methods:
A retrospective review of 34,629 opioid-naïve patients was conducted.
Demographic, comorbidity, complication data and prescription pharmacy claims were analyzed. Patients were sorted according to the number of postoperative prescription refills of opioid pain medication.
Results:
Seventy-three percent of patients required no additional refills outside the perioperative window. Twenty percent required additional refill prescriptions and 6.4% of patients continued to fill opioid medication beyond 6-months postoperatively. Multiple factors increased the risk for increased opioid use including medical and surgical complications, substance use, diabetes,cardiovascular disease, and obesity. Patients with longer duration of opioid use postoperatively had higher rates of medical and surgical complications. Perioperative prescription quantities were 62.9, 78.6, 83.3 tablets for No Refill, Refill, and Prolonged Use groups, respectively.
Conclusions:
Many patient-specific factors for prolonged opioid consumption after distal radius fracture fixation can be identified prior to prescribing postoperative pain management. Patients most at risk for prolonged opioid use can be targeted for alternative pain management options. Surgeons should take a more patient specific approach in prescribing opioid medication after distal radius fracture fixation.
