Thyroidectomy and Parathyroidectomy Opioid Prescription Trends Pre- and Post-2021 Opioid Clinical Practice Guideline Recommendations

Tuesday, October 1, 2024

8:48 AM – 8:54 AM EDT

Location: MBCC, 208

Disclosure(s):

Robert E. Africa, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brian J. McKinnon, MD, MBA, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Viran J. Ranasinghe, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: To evaluate the trends in opioid prescription rates for thyroidectomy and parathyroidectomy and assess the prescription rates of non-opioid analgesics after the guideline recommendations by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) in April 2021.

Methods: This is a retrospective study interrogating de-identified patient data within the TriNetX database from January 1, 2013 to December 31, 2023 in intervals of 3 months. The data includes patients who were prescribed either opioids or non-opioid analgesic within 1-5 days following either thyroid surgery or parathyroidectomy from 83 participating health care institutions in the database. Evaluation of the prescription rates was performed by interrupted time series analysis in Statistical Analysis System (SAS) 9.4 with significance set at p < 0.05 to assess trends before and after the AAO-HNS opioid prescription recommendations.

Results: A total of 64,031 thyroidectomies and 58,076 parathyroidectomies were included, of which 29,681 patients (51.11%) and 13,210 patients (22.74%) received opioids, respectively. There were 5,098 patients (7.96%) in the thyroidectomy group who received non-opioid analgesic and 3,703 patients in the parathyroidectomy group (6.38%). There was an immediate effect of the guideline change indicated by a 3.3% decrease in the opioid prescription rate (p = 0.03). Additionally, there was a significant increase in use over time by 0.13% every 3 months (p < 0.0001). The opioid prescription trend following parathyroidectomy significantly decreased over time by 0.28% every 3 months (p < 0.0001), while the non-opioid prescription rate increased by 0.14% (p < 0.0001).

Conclusions: There was an immediate reduction in the opioid prescription rate after April 2021 for thyroidectomy, and an increasing rate of non-opioid analgesic use over time. The decrease in opioid usage following parathyroidectomy and increasing rate of non-opioid analgesic prescriptions are significant over time.

Presenting Author(s)

Robert E. Africa, MD

Resident
University of Texas Medical Branch Hospitals
Galveston, Texas, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
BM

Brian J. McKinnon, MD, MBA, MPH

Professor, Neurotology
University of Texas Medical Branch Health
Bayou Vista, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Orly M. Coblens, MD

Associate Professor & Residency Program Director
University of Texas Medical Branch at Galveston
Galveston, Texas, United States

Disclosure information not submitted.
Viran J. Ranasinghe, MD

Assistant Professor
University of Texas Medical Branch
Galveston, Texas, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

SS

Sepehr Shabani, MD

Assistant Professor
University of Texas Medical Branch
Galveston, Texas, United States

Disclosure information not submitted.