Brian T Young1, Samuel J Zolin2, Alexandra Ferre3, Vanessa P Ho4, Alexis R Harvey4, Kevin T Beel4, Esther S Tseng4, Kristen Conrad-Schnetz3, Jeffrey A Claridge5. 1. MetroHealth Medical Center, Department of Surgery, Division of Trauma, Critical Care, Burns, & Acute Care Surgery, Cleveland, OH, USA. Electronic address: byoung001@gmail.com. 2. MetroHealth Medical Center, Department of Surgery, Division of Trauma, Critical Care, Burns, & Acute Care Surgery, Cleveland, OH, USA; Cleveland Clinic Foundation, Digestive Disease Institute, Department of General Surgery, Cleveland, OH, USA. 3. Cleveland Clinic Foundation, Digestive Disease Institute, Department of General Surgery, Cleveland, OH, USA. 4. MetroHealth Medical Center, Department of Surgery, Division of Trauma, Critical Care, Burns, & Acute Care Surgery, Cleveland, OH, USA. 5. MetroHealth Medical Center, Department of Surgery, Division of Trauma, Critical Care, Burns, & Acute Care Surgery, Cleveland, OH, USA. Electronic address: jclaridge@metrohealth.org.
Abstract
BACKGROUND: Geriatric patients, age ≥65, frequently require no operation and only short observation after injury; yet many are prescribed opioids. We reviewed geriatric opioid prescriptions following a statewide outpatient prescribing limit. METHODS: Discharge and 30-day pain prescriptions were collected for geriatric patients managed without operation and with stays less than two midnights from May and June of 2015 through 2018. Patients were compared pre- and post-limit and with a non-geriatric cohort aged 18-64. Fall risk was also assessed. RESULTS: We included 218 geriatric patients, 57 post-limit. Patients received fewer discharge prescriptions and lower doses following the limit. However, this trend preceded the limit. Geriatric patients received fewer opioid prescriptions but higher doses than non-geriatric patients. Fall risk was not associated with reduced prescription frequency or doses. CONCLUSIONS: Opioid prescribing has decreased for geriatric patients with minor injuries. However, surgeons have not reduced dosage based on age or fall risk.
BACKGROUND: Geriatric patients, age ≥65, frequently require no operation and only short observation after injury; yet many are prescribed opioids. We reviewed geriatric opioid prescriptions following a statewide outpatient prescribing limit. METHODS: Discharge and 30-day pain prescriptions were collected for geriatric patients managed without operation and with stays less than two midnights from May and June of 2015 through 2018. Patients were compared pre- and post-limit and with a non-geriatric cohort aged 18-64. Fall risk was also assessed. RESULTS: We included 218 geriatric patients, 57 post-limit. Patients received fewer discharge prescriptions and lower doses following the limit. However, this trend preceded the limit. Geriatric patients received fewer opioid prescriptions but higher doses than non-geriatric patients. Fall risk was not associated with reduced prescription frequency or doses. CONCLUSIONS: Opioid prescribing has decreased for geriatric patients with minor injuries. However, surgeons have not reduced dosage based on age or fall risk.
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