Post-operative opioid pain management patterns for patients who receive hip surgery.
Abstract
Identifying optimal, post-operative opioid management strategies is a priority of
health providers and government agencies. At present, there are no studies we are
aware of that have formally investigated opioid prescribing patterns for post-operative
non-arthroplasty orthopedic conditions such as femoroacetabular impingement, nor has
any study investigated the influence of opioid prescription patterns on health care
costs and utilization. We aimed to investigate a subgrouping scheme associated with
post-operative opioid prescription strategies and measure the subgroups' direct and
indirect health care utilization and costs in individuals undergoing non-arthroplasty
orthopedic hip surgery.The study was an observational cohort of routine military clinical
practices. We used cluster analysis to characterize pre-operative (12 months) and
post-operative (24 months) opioid prescription patterns. Linear mixed effects modeling
(with statistical controls for baseline status) identified opioid prescription pattern
subgroups and identified subgroup differences in health care utilization and costs.Two
distinct clusters were identified representing 1) short-duration, high total days'
supply (SD-HD), and 2) long-duration, lesser total days' supply (LD-LD) post-operative
prescription patterns. Significantly higher costs and health care utilization for
both hip-related and non-hip-related variables were consistently identified in the
SD-HD group.Long-term opioid prescription use has been identified as a concern, but
our findings demonstrate that LD-LD post-operative opioid management for hip surgery
recipients was associated with lower costs and utilization. Whether these management
patterns were a reflection of pre-operative health status, impacted pain-related outcomes,
or can be replicated in other orthopedic procedures remains a consideration for future
studies.NA.
Type
Journal articleSubject
HumansPain, Postoperative
Analgesics, Opioid
Adult
Health Care Costs
Patient Acceptance of Health Care
Female
Male
Young Adult
Femoracetabular Impingement
Pain Management
Practice Patterns, Physicians'
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https://hdl.handle.net/10161/16765Published Version (Please cite this version)
10.1186/s13011-017-0094-5Publication Info
Cook, Chad E; Rhon, Daniel I; Lewis, Brian D; & George, Steven Z (2017). Post-operative opioid pain management patterns for patients who receive hip surgery.
Substance abuse treatment, prevention, and policy, 12(1). 10.1186/s13011-017-0094-5. Retrieved from https://hdl.handle.net/10161/16765.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Chad E. Cook
Professor in Orthopaedic Surgery
Dr. Cook is a clinical researcher, physical therapist, and profession advocate with
a long-term history of clinical care excellence and service. His passions include
refining and improving the patient examination process and validating tools used in
day-to-day physical therapist practice. Dr. Cook has authored or co-authored 3 textbooks,
has published over 315 peer reviewed manuscripts and lectures internationally on orthopedic
examination and treatment.
Steven Zachary George
Laszlo Ormandy Distinguished Professor of Orthopaedic Surgery
Dr. George’s primary interest is research involving biopsychosocial models for the
prevention and treatment of chronic musculoskeletal pain disorders. His long term
goals are to 1) improve accuracy for predicting who is going to develop chronic pain;
and 2) identify non-pharmacological treatment options that limit the development of
chronic pain conditions. Dr. George is an active member of the American Physical
Therapy Association, United States Association of the Study of
Brian David Lewis
Assistant Professor of Orthopaedic Surgery
I am an assistant professor in the department of orthopaedics. My sub-specialty interest
is in hip surgery including arthroplasty and non-arthoplasty hip surgery. This includes
the treatment of osteoarthritis, hip dysplasia, hip impingement, labral tears, as
well as various tendon disorders around the hip.The research interests include outcomes
research for hip surgeries, hip movement disorders related to hip conditions, and
factors influencing opioid use in post-surgical
Daniel I. Rhon
Adjunct Assistant Professor in the Department of Orthopaedic Surgery
Alphabetical list of authors with Scholars@Duke profiles.

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