Only Half of Young Surgery Patients Use All of Their Opioid Prescriptions

Opioids are commonly prescribed as postoperative pain management for young patients who undergo orthopaedic surgery, but a new study finds that only approximately half of patients consumed the full amounts of opioids prescribed. S. Clifton Willimon, MD, from Children’s Healthcare of Atlanta, presented these findings at the AAOS 2021 Annual Meeting, and noted that most patients still reported satisfaction with their pain control.

The prospective study enrolled 342 young patients (age range = 5-20 years) who underwent one of seven common orthopaedic surgeries at a single institution. The procedures included: posterior spinal fusion for adolescent idiopathic scoliosis [PSF AIS], epiphysiodesis, closed reduction and percutaneous pinning of supracondylar humerus fracture [CRPP SCH], anterior cruciate ligament reconstruction, knee arthroscopy, shoulder arthroscopy for anterior labral repair, and hip arthroscopy for femoroacetabular impingement).

During the study period, providers prescribed a total of 9,867 tablets and liquid doses of opioid pain medication. The opioids prescribed included: hydrocodone-acetaminophen 5 to 325 mg tablets or hydrocodone-acetaminophen 7.5 to 325 mg/15 mL elixir.

Each patients received an average of 29 tablets or liquid doses per prescription. While 98% of patients filled their prescriptions, the researchers found that only 4,351 tablets and liquid doses of the narcotic medication (44%) were consumed. In addition, less than 10% of patients consumed all of their prescribed medications. Those undergoing PSF AIS and shoulder arthroscopy were most likely to use all the prescribed medications.

Despite the high rate of unused opioid prescriptions, 91% of patients reported being either “satisfied” or “very satisfied” with their pain control, according to patient- or caregiver-completed medication logbooks. Interestingly, Dr. Willimon and researchers observed that female patients and those who consumed all the prescribed narcotics had lower satisfaction rates compared with the entire study cohort.