A new study conducted by Johns Hopkins University researchers reveals that most patients, who are discharged from hospital after undergoing orthopedic surgery did not utilize all the pills they were prescribed, proposing that opioids are routinely overprescribed.
The research team interviewed 93 patients following the 4 weeks after hospital discharge and 85 percent of those who stopped taking the medication still had them stored in a cabinet at home.
The findings also revealed that a majority of the patients had large numbers of pill leftover – 28 percent still had 20 or more tablets in their possession and 24 percent kept doses at least 200 morphine-equivalent.
When interviewed, almost 20 percent of the patients had stopped taking the drugs on the 2nd day following discharge and fewer than half of the patients had stopped at the 2-week mark.
The researchers said nearly 10 percent of the patients still had 80 or more opioid tablets left after they stopped taking them.
The authors note that further research is required to determine how much opioid pain medication patients are actually likely to need after undergoing orthopedic surgery. Since surgeons typically do most of the prescribing, they need to be made aware of the results.
There is currently nothing for surgeons to go on, so they are inclined to be liberal in prescribing painkillers, in order to keep inadequate pain control complaints at a minimum.
Orthopedic surgery patients that volunteered for the study agreed to complete serial surveys, beginning in the hospital and multiple times during a 4-week period post-discharge. Initially 101 patients agreed to comply, but eight dropped out of the study.
Patients had a mix of procedures, including 18 percent involved the knee and hip; 25 percent involved the shoulder; 43 percent the back; and the remaining involved other body parts. Nearly 60 percent of the procedures were performed as inpatient.
Surgeons wrote 121 prescriptions and most involved oxycodone in varying formulations. Seven of the prescriptions were for tramadol, thirteen were for hydromorphone and a few were for opioid medications such as transdermal fentanyl and morphine.
Only 5 percent of the patients called the pain control poor, while most said they were satisfied.
However, only a few of the patients acknowledged the proper storage and disposal of unused opioid pills and even fewer admitted to actually doing so.
After 2 weeks post-op, the patients were interviewed again and 17 percent said they had been prescribed to many pills, while nearly as many said they were prescribed too few and another 27 percent requested a refill during the 2-week time period.
The authors noted that 41 percent of the patients kept some of the tablets after stopping.
The study was published at the American Pain Society’s annual meeting in April 2017.