Cargando…

Opioid Prescription Following Wrist and Ankle Fracture Fixation in Scotland—Tradition Prevails

The American ‘opioid crisis’ is rapidly spreading internationally. Perioperative opioid use increases the risk of long-term opioid use. We review opioid use following wrist and ankle fracture fixation across Scotland, establishing prescribing patterns and associations with patient, injury, or periop...

Descripción completa

Detalles Bibliográficos
Autores principales: Gardner, William T., MacDonald, David R. W., Kennedy, Matthew J., Faulkner, Alastair C., McIntyre, Joshua R., Forget, Patrice, Aitken, Stuart A., Stevenson, Iain M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781195/
https://www.ncbi.nlm.nih.gov/pubmed/35054162
http://dx.doi.org/10.3390/jcm11020468
_version_ 1784638031758622720
author Gardner, William T.
MacDonald, David R. W.
Kennedy, Matthew J.
Faulkner, Alastair C.
McIntyre, Joshua R.
Forget, Patrice
Aitken, Stuart A.
Stevenson, Iain M.
author_facet Gardner, William T.
MacDonald, David R. W.
Kennedy, Matthew J.
Faulkner, Alastair C.
McIntyre, Joshua R.
Forget, Patrice
Aitken, Stuart A.
Stevenson, Iain M.
author_sort Gardner, William T.
collection PubMed
description The American ‘opioid crisis’ is rapidly spreading internationally. Perioperative opioid use increases the risk of long-term opioid use. We review opioid use following wrist and ankle fracture fixation across Scotland, establishing prescribing patterns and associations with patient, injury, or perioperative factors. Six Scottish orthopedic units contributed. A total of 598 patients were included. Patient demographics were similar across all sites. There was variation in anesthetic practice, length of stay, and AO fracture type (p < 0.01). For wrist fractures, 85.6% of patients received a discharge opioid prescription; 5.0% contained a strong opioid. There was no significant variation across the six units in prescribing practice. For ankle fractures, 82.7% of patients received a discharge opioid prescription; 17% contained a strong opioid. Dundee and Edinburgh used more strong opioids; Inverness and Paisley gave the least opioids overall (p < 0.01). Younger patient age, location, and length of stay were independent predictors of increased prescription on binary regression. Despite variability in perioperative practices, discharge opioid analgesic prescription remains overwhelmingly consistent. We believe that the biggest influence lies with the prescriber-institutional ‘standard practice’. Education of these prescribing clinicians regarding the risk profile of opioids is key to reducing their use following surgery, thus lowering long-term opioid dependence.
format Online
Article
Text
id pubmed-8781195
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-87811952022-01-22 Opioid Prescription Following Wrist and Ankle Fracture Fixation in Scotland—Tradition Prevails Gardner, William T. MacDonald, David R. W. Kennedy, Matthew J. Faulkner, Alastair C. McIntyre, Joshua R. Forget, Patrice Aitken, Stuart A. Stevenson, Iain M. J Clin Med Article The American ‘opioid crisis’ is rapidly spreading internationally. Perioperative opioid use increases the risk of long-term opioid use. We review opioid use following wrist and ankle fracture fixation across Scotland, establishing prescribing patterns and associations with patient, injury, or perioperative factors. Six Scottish orthopedic units contributed. A total of 598 patients were included. Patient demographics were similar across all sites. There was variation in anesthetic practice, length of stay, and AO fracture type (p < 0.01). For wrist fractures, 85.6% of patients received a discharge opioid prescription; 5.0% contained a strong opioid. There was no significant variation across the six units in prescribing practice. For ankle fractures, 82.7% of patients received a discharge opioid prescription; 17% contained a strong opioid. Dundee and Edinburgh used more strong opioids; Inverness and Paisley gave the least opioids overall (p < 0.01). Younger patient age, location, and length of stay were independent predictors of increased prescription on binary regression. Despite variability in perioperative practices, discharge opioid analgesic prescription remains overwhelmingly consistent. We believe that the biggest influence lies with the prescriber-institutional ‘standard practice’. Education of these prescribing clinicians regarding the risk profile of opioids is key to reducing their use following surgery, thus lowering long-term opioid dependence. MDPI 2022-01-17 /pmc/articles/PMC8781195/ /pubmed/35054162 http://dx.doi.org/10.3390/jcm11020468 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gardner, William T.
MacDonald, David R. W.
Kennedy, Matthew J.
Faulkner, Alastair C.
McIntyre, Joshua R.
Forget, Patrice
Aitken, Stuart A.
Stevenson, Iain M.
Opioid Prescription Following Wrist and Ankle Fracture Fixation in Scotland—Tradition Prevails
title Opioid Prescription Following Wrist and Ankle Fracture Fixation in Scotland—Tradition Prevails
title_full Opioid Prescription Following Wrist and Ankle Fracture Fixation in Scotland—Tradition Prevails
title_fullStr Opioid Prescription Following Wrist and Ankle Fracture Fixation in Scotland—Tradition Prevails
title_full_unstemmed Opioid Prescription Following Wrist and Ankle Fracture Fixation in Scotland—Tradition Prevails
title_short Opioid Prescription Following Wrist and Ankle Fracture Fixation in Scotland—Tradition Prevails
title_sort opioid prescription following wrist and ankle fracture fixation in scotland—tradition prevails
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781195/
https://www.ncbi.nlm.nih.gov/pubmed/35054162
http://dx.doi.org/10.3390/jcm11020468
work_keys_str_mv AT gardnerwilliamt opioidprescriptionfollowingwristandanklefracturefixationinscotlandtraditionprevails
AT macdonalddavidrw opioidprescriptionfollowingwristandanklefracturefixationinscotlandtraditionprevails
AT kennedymatthewj opioidprescriptionfollowingwristandanklefracturefixationinscotlandtraditionprevails
AT faulkneralastairc opioidprescriptionfollowingwristandanklefracturefixationinscotlandtraditionprevails
AT mcintyrejoshuar opioidprescriptionfollowingwristandanklefracturefixationinscotlandtraditionprevails
AT forgetpatrice opioidprescriptionfollowingwristandanklefracturefixationinscotlandtraditionprevails
AT aitkenstuarta opioidprescriptionfollowingwristandanklefracturefixationinscotlandtraditionprevails
AT stevensoniainm opioidprescriptionfollowingwristandanklefracturefixationinscotlandtraditionprevails
AT opioidprescriptionfollowingwristandanklefracturefixationinscotlandtraditionprevails