Featured Research

from universities, journals, and other organizations

One out of five adult orthopaedic trauma patients sought additional providers for narcotic prescriptions

Date:
August 11, 2014
Source:
American Academy of Orthopaedic Surgeons
Summary:
'Doctor shopping,' the growing practice of obtaining narcotic prescriptions from multiple providers, has led to measurable increases in drug use among postoperative trauma patients, researchers report. The "doctor shopping" patients from the study had an average age of 39.6 12.2 years, and were primarily white (89 percent) and male (63 percent). Forty-four percent were uninsured.

"Doctor shopping," the growing practice of obtaining narcotic prescriptions from multiple providers, has led to measurable increases in drug use among postoperative trauma patients. The study, "Narcotic Use and Postoperative Doctor Shopping in the Orthopaedic Trauma Population," appearing in the August issue of the Journal of Bone & Joint Surgery (JBJS), links doctor shopping to higher narcotic use among orthopaedic patients. The data was presented earlier this year at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

Related Articles


"There has been an alarming rise in opioid use in our country, and the diversion of opioids for non-therapeutic uses is dramatically increasing," said lead study author, orthopaedic surgeon Brent J. Morris, MD. "Many suspect that orthopaedic trauma patients may be at a higher risk for pre-injury narcotic use and 'doctor shopping.'"

Researchers reviewed prescription records for 151 adult patients admitted to an orthopaedic unit at a Level 1 trauma center between January and December 2011. Using the Tennessee Controlled Substance Monitoring Database (CSMD), the study authors reviewed data on narcotic prescriptions obtained three months before, and within six months after, each patient's orthopaedic procedure.

The research found that 20.8 percent of patients sought prescription pain medications from multiple providers. When compared to patients who continued to receive prescriptions and care from a single provider, the "doctor shoppers":

  • Used narcotics four times longer than single provider patients (112 days versus 28 days).
  • Obtained a median of seven narcotic prescriptions compared to two prescriptions for single provider patients.
  • Had a higher morphine equivalent dose (MED) of narcotics each day (43 milligrams versus 26 milligrams).
  • Were 4.5 times more likely to seek out an additional provider if they had a history of preoperative narcotic use.

The "doctor shopping" patients had an average age of 39.6 12.2 years, and were primarily white (89 percent) and male (63 percent). Forty-four percent were uninsured. There were no differences between the single-provider and multiple-provider groups with regard to age, sex, race, injury type, distance between the patient's home and treating hospital, tobacco use, psychiatric history (depression, anxiety, attention deficit hyperactivity disorder, or bipolar disorder), or comorbidities.

"Our study determined that one out of five of our orthopaedic trauma patients obtained narcotic prescriptions from another provider after surgery while still receiving narcotic prescriptions from the treating surgeon," said Dr. Morris.

"Our study highlights the importance of counseling patients in the postoperative period, and that it is important to work together to establish reasonable expectations for pain control as part of treatment plan discussions and follow-up visits," said Dr. Morris. "A standardized pain protocol for specific operative and non-operative treatment plans with an opioid taper may also be helpful."

Study Details

Eligible patients were between the ages of 18 and 65 and had an isolated, operative orthopaedic injury requiring admission from the emergency department to the orthopaedic trauma service. Criteria for exclusion included patients with multiple traumatic injuries, including those with more than one extremity injured; primary residence in a state other than the state of the treating institution; postoperative complication requiring repeat operation; incarceration; and/or incomplete data in the controlled substance monitoring database. The Tennessee Controlled Substance Monitoring Database (CSMD) was used to identify all narcotic prescriptions filled three months prior to hospital admission and six months following discharge from the hospital. The database includes patient names, date of birth and sex; narcotic dosage and quantity; prescriber; and date that the prescription was filled.


Story Source:

The above story is based on materials provided by American Academy of Orthopaedic Surgeons. Note: Materials may be edited for content and length.


Journal Reference:

  1. B. J. Morris, J. W. Zumsteg, K. R. Archer, B. Cash, H. R. Mir. Narcotic Use and Postoperative Doctor Shopping in the Orthopaedic Trauma Population. The Journal of Bone & Joint Surgery, 2014; 96 (15): 1257 DOI: 10.2106/JBJS.M.01114

Cite This Page:

American Academy of Orthopaedic Surgeons. "One out of five adult orthopaedic trauma patients sought additional providers for narcotic prescriptions." ScienceDaily. ScienceDaily, 11 August 2014. <www.sciencedaily.com/releases/2014/08/140811125114.htm>.
American Academy of Orthopaedic Surgeons. (2014, August 11). One out of five adult orthopaedic trauma patients sought additional providers for narcotic prescriptions. ScienceDaily. Retrieved December 22, 2014 from www.sciencedaily.com/releases/2014/08/140811125114.htm
American Academy of Orthopaedic Surgeons. "One out of five adult orthopaedic trauma patients sought additional providers for narcotic prescriptions." ScienceDaily. www.sciencedaily.com/releases/2014/08/140811125114.htm (accessed December 22, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, December 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Touch-Free Smart Phone Empowers Mobility-Impaired

Touch-Free Smart Phone Empowers Mobility-Impaired

Reuters - Innovations Video Online (Dec. 21, 2014) A touch-free phone developed in Israel enables the mobility-impaired to operate smart phones with just a movement of the head. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Earthworms Provide Cancer-Fighting Bacteria

Earthworms Provide Cancer-Fighting Bacteria

Reuters - Innovations Video Online (Dec. 21, 2014) Polish scientists isolate bacteria from earthworm intestines which they say may be used in antibiotics and cancer treatments. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Reuters - Innovations Video Online (Dec. 21, 2014) A team of scientists led by Danish chemist Jorn Christensen says they have isolated two chemical compounds within an existing antipsychotic medication that could be used to help a range of failing antibiotics work against killer bacterial infections, such as Tuberculosis. Jim Drury went to meet him. Video provided by Reuters
Powered by NewsLook.com
Hugging It Out Could Help You Ward Off A Cold

Hugging It Out Could Help You Ward Off A Cold

Newsy (Dec. 21, 2014) Carnegie Mellon researchers found frequent hugs can help people avoid stress-related illnesses. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins