According to the experience of one institution, policies to reduce opioid prescriptions after total shoulder arthroplasty (TSA) did not negatively affect patient satisfaction with pain management. The findings were presented at the AAOS 2021 Annual Meeting by David Bloom, MD, of New York University Langone Health.
Dr. Bloom’s institution implemented an opioid reduction protocol in October 2018, providing researchers the opportunity to evaluate the impact of opioid prescribing reduction on patient satisfaction (measured via Press Ganey surveys) before and after protocol implementation.
The study authors performed a retrospective analysis assessing 201 patients who underwent TSA (91 anatomic and 110 reverse) between 2014 and 2019. This number included inpatient and outpatient procedures, and patients had no previous TSA or history of trauma. Patients eligible for this analysis had no previous TSA or history of trauma, fracture, or connective tissue disease.
In the pre-protocol period, average opioid prescriptions on discharge were 426.3 ± 295 milligram morphine equivalents (MME), or 56.8 tablets of oxycodone 5 mg. After the protocol was implemented, the average prescription dropped to 193.8 ± 199 MME, or 25.8 tablets.
Despite the reduction in prescriptions, however, patients expressed similar levels of satisfaction with their pain control (4.71 pre-protocol vs. 4.74 post-protocol). The findings suggest that doctors can safely prescribe fewer opioids after TSA, without worrying about patient satisfaction and pain control.