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Reducing Disability Durations and Medical Costs for Patients With a Carpal Tunnel Release Surgery Through the Use of Opioid Prescribing Guidelines.

Gaspar, Fraser W. PhD, MPH; Kownacki, Roman MD, MPH; Zaidel, Catherine S. MEM; Conlon, Craig F. MD, PhD; Hegmann, Kurt T. MD, MPH
Journal of Occupational & Environmental Medicine: Post Author Corrections: September 20, 2017
doi: 10.1097/JOM.0000000000001168
Original Article: PDF Only

Objective: The impacts of compliance with opioid prescribing guidelines on disability durations and medical costs for carpal tunnel release (CTR) were examined.

Methods: Using a dataset of insured US employees, opioid prescriptions for 7840 short-term disability cases with a CTR procedure were identified. Opioids prescriptions were compared with the American College of Occupational and Environmental Medicine (ACOEM)'s opioid prescribing guidelines for postoperative, acute pain, which recommends no more than a 5-day supply, a maximum morphine equivalent dose of 50 mg/day, and only short-acting opioids.

Results: Most cases (70%) were prescribed an opioid and 29% were prescribed an opioid contrary to ACOEM's guidelines. Cases prescribed an opioid contrary to guidelines had disability durations 1.9 days longer and medical costs $422 higher than cases prescribed an opioid according to guidelines.

Conclusions: The use of opioid prescribing guidelines may reduce CTR disability durations and medical costs.

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Copyright (C) 2017 by the American College of Occupational and Environmental Medicine