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Opioid legislation and narcotic filling in total hip arthroplasty: descriptive study of time and state-level trends in the United States

机译：髋关节关节置换术中的阿片式立法和麻醉填充：对美国时间和国家级趋势的描述性研究

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The opioid misuse epidemic focused national attention on reducing opioid overprescribing. The purpose of this study is to describe the relationship of time and state-level interventions and opioid filling surrounding total hip arthroplasty (THA) in the United States. A national database with diverse insurance constituents was queried for first-prescription and cumulative perioperative opioid filling volumes and rates in oxycodone 5-mg equivalents (OE’s) in 487,942 patients undergoing primary THA from 30-days pre-operative to 90-days post-operative. Descriptive statistics evaluated pre-legislative and post-legislative opioid filling by state, legislative type, and surgery year. At the national level, initial opioid filling volumes have remained largely unchanged (56.2 OE’s in 2010 to 51.7 OE’s in 2018). Meanwhile, cumulative opioid filling volumes (151.9 OE’s in 2010 to 111.7 OE’s in 2018) have decreased considerably. Rates of initial opioid prescriptions exceeding 90 OE’s were similar in 2010 (6.4%) and 2018 (5.6%). States with legislation targeting duration and volume of opioid prescriptions saw the largest decreases in opioid prescription filling. That is, 75% of states with opioid legislation had large (?10 oxycodone 5-mg equivalents) decreases in cumulative 90-day opioid filling compared to only 20% of states without opioid legislation having large decreases in cumulative 90-day opioid filling. This descriptive study demonstrates decreases in perioperative opioid filling for THA. Although this study was descriptive in nature, states enacting opioid-limiting legislation had larger decreases. Although causal relationships could not be inferred from this analysis, the results suggest that states without legislation could improve prescriber compliance with national goals of decreased opioid overprescribing by enacting opioid-limiting legislation. Level III, retrospective prognostic cohort study.
机译：阿片类药物滥用流行的重点是降低阿片类药物过度规范的关注。本研究的目的是描述在美国周围的时间和状态级干预和阿片类药物填充的关系。鉴定了具有多样化的保险成分的国家数据库，在487,942名患者中，羟考酮5-Mg等同物（OE）在术后30天内从30天进行了30天。描述性统计数据评估了国家，立法类型和外科年度的立法和立法后阿片类药物。在国家一级，初始阿片类药物填充卷在大部分不变（2010年为51.7 OE的56.2 OE）。同时，累积阿片类药物灌装卷（2010年的2010年为111.7 OE的151.9 OE）已大大降低。初始阿片类药物处方的率超过90 OE的2010年（6.4％）和2018年（5.6％）。具有立法靶向持续时间和阿片类药物处方的态度的态度在阿片类药物处方填充中最大的降低。也就是说，累积90天阿片类药物填充的累积90天阿片类药物填充的75％具有大（GT; 10羟基酮5-Mg当量），与累积90天阿片类药物累积大量减少的不同态度，累积为90天阿片类药物填充填充。该描述性研究表明围手术化阿片类药物填充的降低。虽然本研究本质上是描述性的，但颁布了阿片类药物限制立法的州具有更大的减少。虽然无法从这种分析中推断出因果关系，但结果表明，没有立法的国家可以通过制定阿片类药物限制立法来改善符合对阿片类药物减少的国家目标的符合性。第三级，回顾性预后队列研究。

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