Abstract
Purpose :
The current opioid crisis in the United States warrants vigilance in prescribing practices including in ophthalmology. Almost 50% of postoperative prescriptions do not adhere to ophthalmologic opioid-prescribing guidelines, causing concern for the prescription of unnecessary opiates. The purpose of this study was to characterize postoperative opioid prescriptions in ophthalmology over the last 5 years while also observing these practices in different sex and race/ethnicities.
Methods :
This study was conducted in the TriNetX database, a US national bioinformatics database that utilizes ICD and CPT codes and contained over 89 million patients at the time of this study. Opioid prescribing practices were evaluated over the last 5 years and for multiple ocular procedures including trauma, cornea, glaucoma, cataract, strabismus, vitrectomy, and retina with these CPT codes listed in Table 1. Patients had to have an opioid prescription within 2 weeks of their procedure CPT code. All statistics were conducted in excel and R Studio and 95% confidence intervals were utilized.
Results :
Patients who received any ocular procedure had higher odds of a receiving an opioid than not receiving an ocular procedure. Patients with trauma or a retina procedure had the largest prevalence of receiving an opioid at 71.9 and 74.7%. The odds of having an opioid prescription with a trauma or retinal procedure was also the highest at 8.7 (8.2, 9.3) and 9.5 (9.3, 9.8) compared to patients who did not have an ocular trauma or retinal procedure. Compared to a white males, white females, Hispanic females, Hispanic males, and Asian females had lower prevalence odds of receiving an opioid for all procedure categories (Table 1).
Conclusions :
Patients who had a trauma or retinal ocular procedure are more likely to receive an opioids prescription than patients who did not have an ocular trauma or retinal procedure. Based on the large prevalence and odds of opioids for these procedures, evaluations determining the necessity of opioids may best be targeted at trauma and retinal procedures. In addition, Black males and females appeared to have the highest odds of receiving an opioid for the majority of ocular procedures, potentially placing them at higher risk of long-term opioid use.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.