Editor's Note Preoperative opioid use was associated with significantly increased risks of early revisions and 30-day readmissions after total knee and total hip arthroplasties, this study finds. The study included 324,154 patients in a 1-year follow-up group and 159,822 in a 3-year follow-up group. For total knee patients, the hospital…

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Editor's Note Lowering the default number of opioid pills prescribed in an electronic health record (EHR) system is a simple, effective, inexpensive, and potentially scalable intervention to change prescriber behavior and decrease the amount of opioids prescribed postoperatively, finds this study. In this analysis of 1,447 procedures before the default…

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Editor's Note In this study of 34,186 surgical patients in the University of Michigan Health System, 23.1% were taking opioids preoperatively, and the use of opioids was associated with a more negative medical and pain profile. Patient age, tobacco use, illicit drug use, higher pain severity, depression, higher Fibromyalgia Survey…

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Editor's Note Food & Drug Administration (FDA) commissioner, Scott Gottlieb, MD, on July 9 issued a statement on balancing access to appropriate treatment for patients with chronic and end-of-life pain with the need to stem the misuse and abuse of opioids. As the FDA considers new steps to address the…

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Editor's Note In this study, many patients reported unused opioids after joint and spine surgery, infrequent use of nonopioid analgesics, and lack of knowledge on safe opioid storage and disposal. Of 140 patients analyzed, 35% were taking preoperative opioids. Among those who stopped taking opioids after surgery, possession of unused…

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Editor's Note Patients having surgery for degenerative spondylolisthesis (DS) are less likely to be dependent on opioids after surgery than before, this study finds. Of 10,708 DS patients who had surgery between 2000 and 2012, 14.85% were opioid dependent within 12 months before surgery, and 9.90% were opioid dependent 3…

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Editor's Note The Joint Commission on June 25 released new and revised pain assessment and management standards that will be applicable to accredited critical access hospitals and ambulatory care and office-based surgery organizations, effective January 1, 2019. The standards are designed to strengthen an organization’s practices for pain assessment, treatment,…

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Editor's Note Contrary to what some studies are suggesting, use of the local anesthetic liposomal bupivacaine as part of a multimodal approach to postoperative pain did not reduce in-hospital opioid use or opioid-related complications after total knee arthroplasty (TKA) in this study. Researchers analyzed data on 88,830 TKAs performed with…

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Can hospital leaders and surgeons partner to reduce opioid use while maintaining high patient satisfaction scores? Leaders at OSS Orthopaedic Hospital in York, Pennsylvania, answer that question with a yes. Meghan McNelly, PharmD, MHA, FACHE, who was director of pharmacy at OSS when the opioid-reduction project started, says that from…

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Editor's Note Opioid abuse or dependence after major surgical procedures was associated with increased readmission rates and healthcare utilization. Of 16,016,842 patients in the National Readmission Database analyzed, 94,903 (0.6%) had diagnoses of opioid abuse or dependence. Comparing patients with and without opioid abuse or dependence, researchers found that patients…

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