Adherence to legislation limiting opioid prescription duration following musculoskeletal injury.
J Opioid Manag
; 19(7): 103-115, 2023.
Article
en En
| MEDLINE
| ID: mdl-37879665
ABSTRACT
OBJECTIVES:
North Carolina had implemented legislation (Strengthen Opioid Misuse Prevention (STOP) Act) limiting opioid prescriptions to 5 days for acute pain and 7 days for post-operative pain. This study aimed to identify patient, prescriber, and facility characteristics associated with STOP Act adherence for patients with acute or post-surgical musculoskeletal (MSK) conditions.DESIGN:
A three-level hierarchical logistic regression model was used to predict odds of adherence with STOP Act duration limits, accounting for fixed and random effects at the patient, prescriber, and facility levels.SETTING:
A large healthcare system in North Carolina. PATIENTS ANDPARTICIPANTS:
Patients (N = 6,849) presenting from 2018 to 2020 with a diagnosis of an acute MSK injury.INTERVENTIONS:
The STOP Act limited the duration of opioid prescriptions in North Carolina. MAIN OUTCOMEMEASURE:
Prescriptions adhering to the STOP Act duration limits of 5 days (nonoperative) or 7 days (operative) were the primary outcome.RESULTS:
Opioids were compliant with STOP Act duration limits in 69.3 percent of encounters, with 33 percent of variation accounted for by clinician and 29 percent by facility. Patients prescribed >1 opioid (odds ratio (OR) 0.46, 95 percent confidence interval (CI) 0.36, 0.58) had reduced odds of a compliant prescription; surgical patients had increased odds of a compliant prescription (outpatient surgery OR 5.89, 95 percent CI 2.43-14.29; inpatient surgery OR 7.71, 95 percent CI 3.04-19.56). Primary care sports medicine clinicians adhered to legislation less frequently than orthopedic surgeons (OR 0.38, 95 percent CI 0.15, 0.97).CONCLUSIONS:
Most prescriptions adhered to STOP Act legislation. Tailored interventions to improve adherence among targeted groups of prescribers, eg, those treating nonoperative injuries and sport medicine clinicians, could be useful.
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Base de datos:
MEDLINE
Idioma:
En
Revista:
J Opioid Manag
Asunto de la revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2023
Tipo del documento:
Article