Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleOpioid Consumption After Rotator Cuff Repair
Section snippets
Methods
The Humana administrative claims database was the source of patient data and was accessed by use of the PearlDiver Technologies Research Program (PearlDiver, Fort Wayne, IN) in April 2015. Patient data are deidentified and Health Insurance Portability and Accountability Act compliant. This study was deemed institutional review board exempt by our institution. The Humana administrative claims database represents 16 million covered persons and includes both privately or commercially insured
Results
Among 35,155 arthroscopic RCRs performed, 47% of patients were female patients and 58.5% of patients were aged between 60 and 74 years. No patients were excluded. Of the patients, approximately 43% (15,230 of 35,155) had filled an opioid prescription in the 3 months before RCR. Of these, 58.9% had been prescribed opioids at 1 to 3 months before RCR and 41.1% had been prescribed preoperative opioids only in the 1 month before RCR. In addition, 11.86% of patients (4,170 of 35,155) had a
Discussion
We found that preoperative opiate use was rampant, at a rate of 43%, with high rates of patients filling opiate prescriptions before surgery. Filling of preoperative opioid prescriptions was the strongest predictor of postoperative opioid use, and patients with psychiatric diagnoses, fibromyalgia, and low-back pain were also filling significantly more narcotic prescriptions after surgery.
Previous authors have considered how preoperative opioid use may influence postoperative opioid demand and
Conclusions
From a large multicenter database, we found approximately 43% of patients undergoing RCR received opioid medications before RCR. Patients who are prescribed narcotics before RCR are at increased risk of postoperative opioid demand. Patients with psychiatric diagnoses, myalgia, and low-back pain may be at increased risk of prolonged opioid use after surgery.
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The authors report the following potential conflicts of interest or sources of funding: M.B. receives support from Arthrex (consultant). B.R.W. receives support from Arthrex (paid consultant for MEDCON).