Opioid prescribing practices after posterior spinal arthrodesis for adolescent idiopathic scoliosis
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Opioid prescribing practices after posterior spinal arthrodesis for adolescent idiopathic scoliosis Andrew B. Harris1 · Varun Puvanesarajah1 · Majd Marrache1 · Caleb P. Gottlich1 · Michael Raad1 · Richard L. Skolasky1 · Dolores B. Njoku2 · Paul D. Sponseller1 · Amit Jain1 Received: 23 January 2020 / Accepted: 20 April 2020 © Scoliosis Research Society 2020
Abstract Study design Retrospective review. Objective To identify national trends in postoperative opioid prescribing practices after posterior spinal fusion (PSF) in patients with adolescent idiopathic scoliosis (AIS). Summary of background data Opioids are an important component of pain management after PSF for AIS. Given the national opioid crisis, it is important to understand opioid prescribing practices in these patients. Methods Using a commercial prescription drug claims database, we identified AIS patients who underwent PSF from 2010 to 2016 and who were prescribed opioids postoperatively. An initial prescription at hospital discharge of ≥ 90 morphine milligram equivalents daily (MMED) was used to identify patients at risk of overdose according to the US Centers for Disease Control and Prevention (CDC) guidelines. Prescriptions for skeletal muscle relaxants were also identified. α = 0.05. Results We included 3762 patients (75% female) with a mean (± standard deviation) age of 15 ± 2.1 years. 56% of patients filled only 1 opioid prescription after discharge, and 44% had ≥ 1 refills. 91% of opioid prescriptions were for hydrocodone (median strength, 43 MMED; mean strength, 65 ± 270 MMED) or oxycodone formulations (median strength, 60 MMED; mean strength, 79 ± 174 MMED). 82% of prescriptions complied with CDC guidelines ( 1 prescription declined from 54% in 2010 to 31% in 2016 (p
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