Opioid prescribing patterns for distal radius fractures in the ambulatory setting: A 10-year retrospective study

Brian Pettitt-Schieber; Robert P. Lesko; Fei Wang; Jinesh Shah; Joseph A. Ricci

doi:10.5055/jom.0862

Authors

Brian Pettitt-Schieber, MD
Robert P. Lesko, MD
Fei Wang, BA
Jinesh Shah, MD
Joseph A. Ricci, MD https://orcid.org/0000-0002-5791-4378

DOI:

https://doi.org/10.5055/jom.0862

Keywords:

wrist fracture, quality improvement, pain management, evidence-based medicine

Abstract

Objective: Distal radius fractures (DRFs) are one of the most common orthopedic injuries, with most managed in the nonoperative ambulatory setting. The objectives of this study are to examine National Health Center Statistics (NHCS) data for DRF treated in the nonoperative ambulatory setting to identify opioid and nonopioid analgesic prescribing patterns and to determine demographic risk factors for prescription of these medications.

Design, setting, patients, and measures: This study is a retrospective analysis of data collected by the NHCS from 2007 to 2016. Utilizing International Classification of Diseases codes, all visits to emergency departments and doctors’ offices for DRFs were identified. Variables of interest included demographic data, expected payment source, and prescription of opioid or nonopioid analgesics.

Results: During the study timeframe, 15,572,531 total visits for DRFs were recorded. DRF visits requiring opioid and nonopioid analgesic prescriptions increased over time. Patients aged 45-64 years were significantly more likely to receive an opioid prescription than any other age group (p < 0.05). Opioid prescription was positively correlated with the use of workers’ compensation and negatively correlated with patients receiving services under charity care (p < 0.05).

Conclusions: Prescriptions of both opioid and nonopioid analgesic medications for DRF have been steadily increasing over time in the nonoperative ambulatory setting, with middle-aged adults most likely to receive an opioid prescription. Opioid prescription rates differ significantly between patients utilizing workers’ compensation and patients receiving services under charity care, suggesting that socioeconomic factors play a role in prescribing patterns.

Author Biographies

Brian Pettitt-Schieber, MD

Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York

Robert P. Lesko, MD

Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland

Fei Wang, BA

Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York

Jinesh Shah, MD

Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut

Joseph A. Ricci, MD

Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York

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