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Accuracy of self-reported opioid use in orthopaedic trauma patients

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Opioids have long been a mainstay of treatment for pain in patients with orthopaedic injuries, but little is known about the accuracy of self-reported narcotic usage in orthopaedic trauma. The purpose of this study is to evaluate the accuracy of self-reported opioid usage in orthopaedic trauma patients.

Methods

A retrospective review of all new patients presenting to the orthopaedic trauma clinic of a level 1 trauma centre with a chief complaint of recent orthopaedic-related injury over a 2-year time frame was conducted. Participants were administered a survey inquiring about narcotic usage within the prior 3 months. Responses were cross-referenced against a query of a statewide prescription drug monitoring program system.

Results

The study comprised 241 participants; 206 (85.5%) were accurate reporters, while 35 (14.5%) were inaccurate reporters. Significantly increased accuracy was associated with hospital admission prior to clinic visit (β = − 1.33; χ2 = 10.68, P < 0.01; OR: 0.07, 95% CI 0.01–0.62). Decreased accuracy was associated with higher pre-visit total morphine equivalent dose (MED) (β = 0.002; χ2 = 11.30, P < 0.01), with accurate reporters having significantly lower pre-index visit MED levels compared to underreporters (89.2 ± 208.7 mg vs. 249.6 ± 509.3 mg; P = 0.04). An Emergency Department (ED) visit prior to the index visit significantly predicted underreporting (β = 0.424; χ2 = 4.28, P = 0.04; OR: 2.34, 95% CI 1.01–5.38).

Conclusion

This study suggests that most new patients presenting to an orthopaedic trauma clinic with acute injury will accurately report their narcotic usage within the preceding 3 months. Prior hospital admissions increased the likelihood of accurate reporting while higher MEDs or an ED visit prior to the initial visit increased the likelihood of underreporting.

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Availability of data and materials

The data that support the findings of this study are available from the corresponding author (J.G.L.) upon reasonable request.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA

    Fady Y. Hijji, Tyler Sanda, Scott D. Huff, Andrew W. Froehle, Joseph D. Henningsen, Andrew D. Schneider, Joseph G. Lyons, Humza M. Mian, Jennifer Jerele & Indresh Venkatarayappa

Authors
  1. Fady Y. Hijji
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  2. Tyler Sanda
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  3. Scott D. Huff
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  4. Andrew W. Froehle
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  5. Joseph D. Henningsen
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  6. Andrew D. Schneider
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  7. Joseph G. Lyons
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  8. Humza M. Mian
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  9. Jennifer Jerele
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  10. Indresh Venkatarayappa
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Contributions

All authors were involved in the study design, collection of data, manuscript preparation, and final approval of the manuscript.

Corresponding author

Correspondence to Joseph G. Lyons.

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Conflict of interests

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

This study was approved by our institutional review board. Due to the retrospective nature of this work, a waiver of informed consent was granted. This study was approved by the relevant institutional ethical board and was in full compliance with the Declaration of Helsinki and its appendages.

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Hijji, F.Y., Sanda, T., Huff, S.D. et al. Accuracy of self-reported opioid use in orthopaedic trauma patients. Eur J Orthop Surg Traumatol 33, 185–190 (2023). https://doi.org/10.1007/s00590-021-03178-8

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  • DOI: https://doi.org/10.1007/s00590-021-03178-8

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