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Post-operative opioid pain management patterns for patients who receive hip surgery.

dc.contributor.author Cook, Chad E
dc.contributor.author Rhon, Daniel I
dc.contributor.author Lewis, Brian D
dc.contributor.author George, Steven Z
dc.date.accessioned 2018-05-24T15:11:03Z
dc.date.available 2018-05-24T15:11:03Z
dc.date.issued 2017-03-16
dc.identifier.issn 1747-597X
dc.identifier.issn 1747-597X
dc.identifier.uri https://hdl.handle.net/10161/16765
dc.description.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.
dc.language eng
dc.publisher Springer Science and Business Media LLC
dc.relation.ispartof Substance abuse treatment, prevention, and policy
dc.relation.isversionof 10.1186/s13011-017-0094-5
dc.subject Humans
dc.subject Pain, Postoperative
dc.subject Analgesics, Opioid
dc.subject Adult
dc.subject Health Care Costs
dc.subject Patient Acceptance of Health Care
dc.subject Female
dc.subject Male
dc.subject Young Adult
dc.subject Femoracetabular Impingement
dc.subject Pain Management
dc.subject Practice Patterns, Physicians'
dc.title Post-operative opioid pain management patterns for patients who receive hip surgery.
dc.type Journal article
duke.contributor.id Cook, Chad E|0329305
duke.contributor.id Rhon, Daniel I|0886950
duke.contributor.id Lewis, Brian D|0651141
duke.contributor.id George, Steven Z|0718420
dc.date.updated 2018-05-24T15:11:01Z
pubs.issue 1
pubs.organisational-group School of Medicine
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Orthopaedics, Physical Therapy
pubs.organisational-group Orthopaedics
pubs.organisational-group Clinical Science Departments
pubs.publication-status Published
pubs.volume 12
duke.contributor.orcid Rhon, Daniel I|0000-0002-4320-990X
duke.contributor.orcid Lewis, Brian D|0000-0001-8821-5468


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