TY - JOUR
T1 - Association between sex and perioperative opioid prescribing for total joint arthroplasty
T2 - a retrospective population-based study
AU - Soffin, Ellen M.
AU - Wilson, Lauren A.
AU - Liu, Jiabin
AU - Poeran, Jashvant
AU - Memtsoudis, Stavros G.
N1 - Publisher Copyright:
© 2021 British Journal of Anaesthesia
PY - 2021/6
Y1 - 2021/6
N2 - Background: Scarce data exist on differential opioid prescribing between men and women in the pre-, peri-, and postoperative phases of care among patients undergoing total hip/knee arthroplasty (THA/TKA). Methods: In this retrospective population-based study, Truven Health MarketScan claims data were used to establish differences between men and women in (1) opioid prescribing in the year before THA/TKA surgery, (2) the amount of opioids prescribed at discharge, and (3) chronic opioid prescribing (3–12 months after surgery). Multivariable regression models measured odds ratios (OR) with 95% confidence intervals (95% CI). Results: Among 29 038 THAs (42% men) and 48 523 TKAs (52% men) men (compared with women) were less likely to receive an opioid prescription in the year before surgery (54% vs 60%, and 54% vs 60% for THA and TKA, respectively); P<0.001. However, in multivariable analyses male sex was associated with higher total opioid dosages prescribed at discharge after THA (OR=1.04; 95% CI 1.03, 1.06) and TKA (OR=1.05; 95% CI 1.04, 1.06); both P<0.001. Chronic opioid prescribing was found in 10% of the cohort (THA: n=2333; TKA: n=5365). Here, men demonstrated lower odds of persistent opioid prescribing specifically after THA (OR=0.90; 95% CI 0.82, 0.99) but not TKA (OR=0.96; 95% CI 0.90, 1.02); P=0.026 and P=0.207, respectively. Conclusions: We found sex-based differences in opioid prescribing across all phases of care for THA/TKA. The results highlight temporal opportunities for targeted interventions to improve outcomes after total joint arthroplasty, particularly for women, and to decrease chronic opioid prescribing.
AB - Background: Scarce data exist on differential opioid prescribing between men and women in the pre-, peri-, and postoperative phases of care among patients undergoing total hip/knee arthroplasty (THA/TKA). Methods: In this retrospective population-based study, Truven Health MarketScan claims data were used to establish differences between men and women in (1) opioid prescribing in the year before THA/TKA surgery, (2) the amount of opioids prescribed at discharge, and (3) chronic opioid prescribing (3–12 months after surgery). Multivariable regression models measured odds ratios (OR) with 95% confidence intervals (95% CI). Results: Among 29 038 THAs (42% men) and 48 523 TKAs (52% men) men (compared with women) were less likely to receive an opioid prescription in the year before surgery (54% vs 60%, and 54% vs 60% for THA and TKA, respectively); P<0.001. However, in multivariable analyses male sex was associated with higher total opioid dosages prescribed at discharge after THA (OR=1.04; 95% CI 1.03, 1.06) and TKA (OR=1.05; 95% CI 1.04, 1.06); both P<0.001. Chronic opioid prescribing was found in 10% of the cohort (THA: n=2333; TKA: n=5365). Here, men demonstrated lower odds of persistent opioid prescribing specifically after THA (OR=0.90; 95% CI 0.82, 0.99) but not TKA (OR=0.96; 95% CI 0.90, 1.02); P=0.026 and P=0.207, respectively. Conclusions: We found sex-based differences in opioid prescribing across all phases of care for THA/TKA. The results highlight temporal opportunities for targeted interventions to improve outcomes after total joint arthroplasty, particularly for women, and to decrease chronic opioid prescribing.
KW - opioid prescribing
KW - opioids
KW - sex differences
KW - total hip arthroplasty
KW - total joint arthroplasty
KW - total knee arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85101874431&partnerID=8YFLogxK
U2 - 10.1016/j.bja.2020.12.046
DO - 10.1016/j.bja.2020.12.046
M3 - Article
C2 - 33674073
AN - SCOPUS:85101874431
SN - 0007-0912
VL - 126
SP - 1217
EP - 1225
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 6
ER -