Trends in pain medication prescriptions and satisfaction scores in spine surgery patients at a single institution

Erik Wang, Dennis Vasquez-Montes, Deeptee Jain, Lorraine H. Hutzler, Joseph A. Bosco, Themistocles S. Protopsaltis, Aaron J. Buckland, Charla R. Fischer

Research output: Contribution to journalArticlepeer-review

Abstract

Background: As the opioid crisis has gained national attention, there have been increasing efforts to decrease opioid usage. Simultaneously, patient satisfaction has been a crucial metric in the American health care system and has been closely linked to effective pain management in surgical patients. The purpose of this study was to examine rates of pain medication prescription and concurrent patient satisfaction in spine surgery patients. Methods: A total of 1729 patients undergoing spine surgery between June 25, 2017, and June 30, 2018, at a single institution by surgeons performing >20 surgeries per quarter, with medication data during hospitalization available, were assessed. Patients were evaluated for nonopioid pain medication prescription rates and morphine milligram equivalents (MME) of opioids used during hospitalization. Of the total cohort, 198 patients were evaluated for Press Ganey Satisfaction Survey responses. A v2 test of independence was used to compare percentages, and 1-way analysis of variance was used to compare means across quarters. Results: The mean total MME per patient hospitalization was 574.46, with no difference between quarters. However, mean MME per day decreased over time (P ¼ .048), with highest mean 91.84 in Quarter 2 and lowest 77.50 in Quarter 4. Among all procedures, acetaminophen, nonsteroidal anti-inflammatory drugs, and steroid prescription rates increased, whereas benzodiazepine and c-aminobutyric acid–analog prescriptions decreased. There were no significant differences between quarters for mean hospital ratings (P ¼ .521) nor for responses to questions from the Press Ganey Satisfaction Survey regarding how often staff talk about pain (P ¼ .164), how often staff talk about pain treatment (P ¼ .595), or whether patients recommended the hospital (P ¼ .096). There were also no differences between quarters for responses in all other patient satisfaction questions (P value range, .359–.988). Conclusions: Over the studied time period, opioid use decreased and nonopioid prescriptions increased during hospitalization, whereas satisfaction scores remained unchanged. These findings indicate an increasing effort in reducing opioid use among providers and suggest the ability to do so without affecting overall satisfaction rates.

Original languageEnglish
Pages (from-to)1023-1030
Number of pages8
JournalInternational Journal of Spine Surgery
Volume14
Issue number6
DOIs
StatePublished - Dec 1 2020

Keywords

  • Opioids
  • Pain medication
  • Patient satisfaction
  • Press Ganey
  • Spine surgery

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