Accuracy of self-reported opioid use in orthopaedic trauma patients.

Abstract

PURPOSE:

Opioids have long been a mainstay of treatment for pain in patients with orthopaedic injuries, but little is known about the accuracy of self-reported narcotic usage in orthopaedic trauma. The purpose of this study is to evaluate the accuracy of self-reported opioid usage in orthopaedic trauma patients.

METHODS:

A retrospective review of all new patients presenting to the orthopaedic trauma clinic of a level 1 trauma centre with a chief complaint of recent orthopaedic-related injury over a 2-year time frame was conducted. Participants were administered a survey inquiring about narcotic usage within the prior 3 months. Responses were cross-referenced against a query of a statewide prescription drug monitoring program system.

RESULTS:

The study comprised 241 participants; 206 (85.5%) were accurate reporters, while 35 (14.5%) were inaccurate reporters. Significantly increased accuracy was associated with hospital admission prior to clinic visit (β = - 1.33; χ2 = 10.68, P < 0.01; OR: 0.07, 95% CI 0.01-0.62). Decreased accuracy was associated with higher pre-visit total morphine equivalent dose (MED) (β = 0.002; χ2 = 11.30, P < 0.01), with accurate reporters having significantly lower pre-index visit MED levels compared to underreporters (89.2 ± 208.7 mg vs. 249.6 ± 509.3 mg; P = 0.04). An Emergency Department (ED) visit prior to the index visit significantly predicted underreporting (β = 0.424; χ2 = 4.28, P = 0.04; OR: 2.34, 95% CI 1.01-5.38).

CONCLUSION:

This study suggests that most new patients presenting to an orthopaedic trauma clinic with acute injury will accurately report their narcotic usage within the preceding 3 months. Prior hospital admissions increased the likelihood of accurate reporting while higher MEDs or an ED visit prior to the initial visit increased the likelihood of underreporting.

• Authors: Fady Y Hijji, Tyler Sanda, Scott D Huff, Andrew W Froehle, Joseph D Henningsen, Andrew D Schneider, Joseph G Lyons, Humza M Mian, Jennifer Jerele, Indresh Venkatarayappa
• Journal: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie (Eur J Orthop Surg Traumatol) Vol. 33 Issue 1 Pg. 185-190 (Jan 2023) ISSN: 1432-1068 [Electronic] France
• PMID: 34981218 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.

Chemical References

• Analgesics, Opioid
• Narcotics
• Morphine

Topics

• Humans
• Analgesics, Opioid (therapeutic use)
• Self Report
• Orthopedics
• Opioid-Related Disorders
• Narcotics (therapeutic use)
• Emergency Service, Hospital
• Morphine
• Retrospective Studies