AAOS 2014: Postoperative “Doctor Shopping” & Narcotic Use in Orthopedic Patients

The Particulars: Recent studies have shown that prescription drug abuse is on the rise throughout the United States. With this phenomenon has come a rise in “doctor shopping,” the practice of visiting various providers to obtain more than one narcotic prescription. Few studies have examined the rate of doctor shopping among postoperative orthopedic patients.

Data Breakdown: Researchers in Tennessee reviewed prescription records for 151 adults admitted to an orthopedic unit at a level one trauma center in 2011. Specifically, investigators reviewed data on narcotic prescriptions obtained 3 months prior to each patient’s orthopedic procedure and within 6 months after the procedure. Overall, 20% of patients were doctor shopping. Those who shopped for doctors used narcotics four times longer than those with a single provider (112 days vs 28 days). They also had an average of five more narcotic prescriptions and had a higher morphine equivalent dose each day (43 mg vs 26 mg). Patients with a history of preoperative narcotic use were 4.5 times more likely to be doctor shoppers.

Take Home Pearls: Doctor shopping appears to be common among postoperative orthopedic patients and associated with increased narcotic use. Patients should be closely monitored for narcotic prescriptions and related requests following orthopedic surgery.

 

 

 

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