Effects of Ohio's opioid prescribing limit for the geriatric minimally injured trauma patient

Am J Surg. 2020 Mar;219(3):400-403. doi: 10.1016/j.amjsurg.2019.10.041. Epub 2019 Nov 11.

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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / therapeutic use*
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Ohio
  • Pain Management*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Retrospective Studies
  • Wounds and Injuries / drug therapy*

Substances

  • Analgesics, Opioid