Doctors in Michigan adhered to a strict five-day limit on opioid pain medication prescriptions for surgery patients, with no negative impact on patient-reported pain levels or satisfaction, according to a new study.
This study is vital as it explores whether opioid prescribing limits affect patients’ experiences post-surgery.
Understanding Opioid Prescribing Limits
Opioid prescribing limits are put in place to reduce the risk of long-term opioid use, opioid use disorder, accidental overdose, and unauthorized use of leftover pills.
The state of Michigan, for example, imposed a seven-day supply limit on opioids, while the state’s largest insurer, Blue Cross Blue Shield of Michigan (BCBSM), enacted an even stricter five-day supply limit for all surgeries.
Researchers at the University of Michigan conducted a study to determine how these opioid prescribing limits affected patients’ experiences.
They examined adults who underwent common surgeries, such as appendix or gallbladder removal, hernia repair, or hysterectomy, before and after the implementation of BCBSM’s five-day limit.
Surprising Results
Contrary to expectations, patients reported no change in pain levels or satisfaction after the five-day opioid limit was enforced. Even patients who had been taking opioids for other reasons before surgery did not experience increased pain or decreased satisfaction, despite a decrease in opioid prescribing.
Understanding the effects of opioid prescribing limits on patients’ experiences is crucial, as these limits are now common practice.
Reducing opioid prescriptions while ensuring patients’ comfort and pain management is a delicate balance that needs to be struck.
The research team used data from the Michigan Surgical Quality Collaborative (MSQC), which collects information from patients who have undergone various surgeries in 70 Michigan hospitals.
Patients are surveyed about their pain, satisfaction, and any regrets after their surgeries.
The team combined this anonymized MSQC data with data on controlled substance prescription fills from the state’s prescription drug monitoring program.
This allowed them to analyze opioid prescribing and patient experiences in the period before and after the five-day limit was enforced.
The study involved 1,323 BCBSM patients who underwent common surgeries in the 13 months before the limit and 4,722 patients who had surgery in the 20 months after the limit was enforced.
The majority of patients were non-Hispanic white, with an average age of under 49.
The surgeries included in the study were common procedures such as laparoscopic gallbladder removal, minor hernia repairs, laparoscopic appendectomy, laparoscopic hysterectomy, as well as more invasive procedures like open hysterectomies, major hernia repairs, and colon removal.
Key Findings
The patient experience, including pain levels and satisfaction, remained unchanged after the five-day opioid limit.
Even patients who had been taking opioids before surgery did not report increased pain or decreased satisfaction.
While the percentage of prescribers who prescribed opioids did not change, fewer patients filled opioid prescriptions, possibly due to pharmacists rejecting non-compliant prescriptions.
The study suggests that opioid prescribing limits may not worsen patient experience for common, less-invasive procedures.
However, further research is needed to understand the impact of these limits on patients undergoing more painful surgeries, such as knee replacements and spine surgery.
The study provides valuable insights into the impact of opioid prescribing limits on patient experiences following surgery.
While these limits aim to reduce opioid misuse and its associated risks, they should be implemented carefully, considering the diverse pain management needs of patients undergoing various types of surgeries.
Balancing pain control and opioid reduction is essential for the well-being of surgery patients.
The research findings can be found in JAMA Health Forum.
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