Abstract
Objective
To assess provider and practice characteristics that drive opioid prescription behavior
using the American Urological Association census data.
Methods
Stratified weighted analysis using 1,157 census samples was performed to represent
12,660 urologists who practiced in the United States in 2018. We compared urologists
according to their opioid prescription patterns to evaluate factors and motivations
behind opioid use in the post-operative setting.
Results
Overall, 11,205 (88.5%) urologists prescribe opioids in the post-operative setting.
The presence of procedure-specific institutional prescribing guidelines was associated
with a greater tendency to prescribe ≤10 pills, and lesser tendency to prescribe 11
to 49 and ≥50 tablets following open abdominal (P = .003), laparoscopic (P < .001), scrotal (P < .001), and endoscopic surgeries (P < .001). The presence of institutional prescribing guidelines was associated with
decreasing opioid prescriptions over a three-year period whereas not having guidelines
was associated with an unchanged prescription practice over time. Basing current prescriptions
on what was given to prior patients was reported by 85% and was more likely to result
in an unchanged amount of prescriptions over time (29.2% vs 13.3%, P = .007). Motivations to avoid patient phone calls were reported by 23.8% and were
more likely to increase the opioids provided within the next 3 years (3.2% vs 0.1%,
P < .001).
Conclusion
Practitioners who endorsed using institutional guidelines prescribed fewer opioids
following all types of surgery and were more likely to decrease their prescription
behavior over time. This data supports continued efforts to provide urologists with
more evidence-based guidance on best practice opioid prescribing in the future.
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Article info
Publication history
Published online: September 05, 2021
Accepted:
August 23,
2021
Received:
June 18,
2021
Footnotes
Funding Support: none.
Financial Disclosure: All authors declare no conflict of interests.
Consent for Publication: All authors provide consent for publication.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
