CME OnDemand: 2022 AOFAS Annual Meeting-Predictors of High-Dose Initial Opioid Prescriptions in Primary Osteoarthritis: A Single Institution Analysis

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This study aimed to determine the incidence of high-dose initial opioid prescriptions in patients with osteoarthritis (OA) and identify risk factors for receiving such prescriptions. A retrospective chart review was conducted on opioid-naïve adult patients with OA at a single academic institution between 2013 and 2020. Of the 1,527 patients included, 21.5% received high-dose prescriptions (daily oral morphine equivalents ≥50).<br /><br />The study found several significant demographic and comorbid differences between the low-dose and high-dose prescription cohorts. The high-dose cohort was younger, less obese, and composed of more males and Caucasians. They were also more likely to have received their prescription from a non-orthopedic provider. The majority of high-dose prescriptions were for oxycodone, while low-dose prescriptions were more commonly hydrocodone-acetaminophen and tramadol.<br /><br />In terms of comorbidities, the high-dose cohort had higher rates of asthma, chronic kidney disease, chronic obstructive pulmonary disease, depression, dementia, diabetes, heart failure, and hypertension. On the other hand, the low-dose cohort had higher rates of hyperlipidemia, heart disease, and osteoporosis. The high-dose cohort also had a significantly larger Charlson Comorbidity Index score.<br /><br />The study identified several independent predictors for high-dose initial opioid prescriptions in OA patients. These included younger age, lower BMI, white race, receiving the prescription from a non-orthopedic provider, hip OA, higher Charlson Comorbidity Index scores, and depression.<br /><br />In conclusion, this study highlights the factors associated with high-dose initial opioid prescriptions in OA patients. Understanding these predictors can help healthcare providers identify patients at risk for receiving high-dose prescriptions and develop strategies to mitigate the potential risks of opioid use in this population.

Asset Subtitle

Charles Johnson, Ryan J. O'Leary, Caronline P. Hoch, Daniel J. Scott, MD, MBA, Christopher E. Gross, MD

Keywords

high-dose initial opioid prescriptions

osteoarthritis

risk factors

retrospective chart review

opioid-naïve

comorbid differences

Charlson Comorbidity Index score

independent predictors

non-orthopedic provider

opioid use