Due to the opioid epidemic, our service developed a cultural change highlighted by decreasing discharge opioids after lower extremity arthroplasty. However, concern of potentially increasing refill requests exists. As such, the goal of this study was to analyze whether decreased discharge opioids led to increased postoperative opioid refills. We retrospectively reviewed 19,428 patients undergoing a primary hip or knee arthroplasty at a single institution from 2016–2019. Patients that underwent secondary procedures within that timeframe were excluded. Two-thousand two-hundred and forty-one patients (12%) were on narcotics preoperatively or had chronic pain syndrome. Two reductions in routine discharge narcotics were performed over this timeframe. First, 8,898 patients routinely received 750 morphine milligram equivalents (MMEs). After the first reduction, 4,842 patients routinely received 520 MMEs. After a second reduction, 5,688 patients routinely received 320 MMEs. We analyzed refill rates, refill MMEs, and whether discharge MMEs were associated with refill MMEs in a multivariate model.Introduction
Methods
