Reducing Disability Durations and Medical Costs for Patients With a Carpal Tunnel Release Surgery Through the Use of Opioid Prescribing Guidelines

J Occup Environ Med. 2017 Dec;59(12):1180-1187. doi: 10.1097/JOM.0000000000001168.

Abstract

Objective: The impacts of compliance with opioid prescribing guidelines on disability durations and medical costs for carpal tunnel release (CTR) were examined.

Methods: Using a dataset of insured US employees, opioid prescriptions for 7840 short-term disability cases with a CTR procedure were identified. Opioids prescriptions were compared with the American College of Occupational and Environmental Medicine (ACOEM)'s opioid prescribing guidelines for postoperative, acute pain, which recommends no more than a 5-day supply, a maximum morphine equivalent dose of 50 mg/day, and only short-acting opioids.

Results: Most cases (70%) were prescribed an opioid and 29% were prescribed an opioid contrary to ACOEM's guidelines. Cases prescribed an opioid contrary to guidelines had disability durations 1.9 days longer and medical costs $422 higher than cases prescribed an opioid according to guidelines.

Conclusions: The use of opioid prescribing guidelines may reduce CTR disability durations and medical costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analgesics, Opioid / economics
  • Analgesics, Opioid / therapeutic use*
  • Carpal Tunnel Syndrome / drug therapy*
  • Carpal Tunnel Syndrome / economics
  • Carpal Tunnel Syndrome / surgery
  • Databases, Factual
  • Disability Evaluation
  • Disabled Persons / statistics & numerical data*
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Pain / drug therapy
  • Pain / economics
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / statistics & numerical data
  • United States
  • Young Adult

Substances

  • Analgesics, Opioid