PainRelief.com: What are the main findings?

Response: We found that the opioid prescribing limit was associated with an immediate 3-4 pill decrease in opioid prescribing after surgery. Despite this decrease, the limit was not associated with changes in patient-reported pain control, satisfaction with care, or amount of regret undergoing surgery.

Interestingly, even though the limit was only intended to restrict opioid prescribing for patients who were new to opioids, we also found that the limit was associated with decreased opioid prescribing to patients who had recently taken opioids before surgery. Fortunately, their patient-reported outcomes also did not change after limit implementation, despite this unintended spillover effect.

PainRelief.com: What should readers take away from your report?

Response: For adults undergoing common general surgical procedures, opioid prescribing limits may be able to modestly decrease opioid prescribing without worsening patient-reported outcomes.

PainRelief.com: What recommendations do you have for future research as a result of this study?

Response: It is important not to assume that the results of this study generalize to all surgical procedures. Our study involved patients who primarily underwent relatively non-invasive procedures. It did not include patients undergoing invasive procedures with high opioid needs, such as knee replacement and spine surgery.

For those patients, opioid prescribing limits likely reduced opioid prescribing to a greater degree than in our study, potentially increasing the risk of worsened patient-reported outcomes. Future studies should evaluate this possibility. 

No disclosures

Citation:

Chua K, Nguyen TD, Brummett CM, et al. Changes in Surgical Opioid Prescribing and Patient-Reported Outcomes After Implementation of an Insurer Opioid Prescribing Limit. JAMA Health Forum. 2023;4(10):e233541.
https://jamanetwork.com/journals/jama-health-forum/fullarticle/2810447#:~:text=Conclusions%20This%20cross%2Dsectional%20analysis,with%20worsened%20patient%2Dreported%20outcomes.

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Last Updated on October 14, 2023 by PainRelief.com