Orthopaedic Resident Opioid Prescribing Practices
BACKGROUND: The U.S. opioid epidemic has become a recent focus for public health treatment and prevention strategies. Orthopaedic surgeons prescribe more narcotics than physicians in any other specialty. No study has yet examined the prescribing practices of orthopaedic surgery residents. Characterization of current resident prescribing habits could help in the implementation of educational programs and guidelines.
PURPOSE: To quantify opioid prescribing practices by orthopaedic surgery residents nationally and to identify influential factors.
METHODS: Orthopaedic surgery residents nationally were polled via a REDCap electronic survey distributed to the program coordinators and chief residents of U.S. accredited orthopaedic surgery residency programs beginning in November 2018. The survey consisted of questions regarding the number of opioids prescribed following seven common orthopaedic surgery procedures, as well as a series of questions regarding the residents' PGY level, training program (academic versus community), and their own perspective on their prescribing practices.
RESULTS: 35 residents from 12 states have responded so far. Preliminary data analysis demonstrates that the highest mean number of opioids are prescribed after spinal fusion surgery (52 pills) and the lowest after upper extremity soft tissue procedures (10 pills). Higher rates of opioid prescribing are associated with academic residency programs, PGY level 2, and lack of a state prescription monitoring program. All respondents indicated that they believed educational guidelines regarding prescribing practices would be helpful.
CONCLUSIONS: Opioid-prescribing practices of orthopaedic surgery residents are influenced by program type, PGY level, and presence of a state opioid monitoring program.
LEVEL OF EVIDENCE: Level IV case series.