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Text Messaging Tracks Use of Postop Opioid Prescriptions

TUESDAY, March 30, 2021 -- Self-reported data via text messaging revealed that patients did not use about 60 percent of prescribed opioid tablets following common orthopedic or urologic procedures, according to a study published online March 25 in JAMA Network Open.

Anish K. Agarwal, M.D., from the University of Pennsylvania in Philadelphia, and colleagues used an automated text messaging system to assess the difference between the number of opioid tablets prescribed and the self-reported number of tablets taken as well as self-reported pain intensity and the ability to manage pain after common orthopedic and urologic procedures in 919 adults. Data for this quality improvement study were collected via text message until postoperative day 28 during the period from May 1 to Dec. 31, 2019.

The researchers found that the mean pain scores on day 4 were 4.72, with a mean change by day 21 of −0.40, after orthopedic procedures, and 3.48, with a mean change by day 21 of −1.50, after urologic procedures. The mean score for the ability to manage pain was 7.32 on day 4 for orthopedic procedures, with a mean change of −0.80 by day 21, and 7.34 on day 4 for urologic procedures, with a mean change of 0.80 by day 14. For orthopedic procedures, the median quantity of opioids prescribed for patients was high versus self-reported consumption (20 tablets versus six tablets used), with similar findings for patients who underwent urologic procedures (seven tablets versus one tablet used). During the study period, 60.7 percent of tablets were unused and 64.1 percent of patients reported using less than half of the prescribed amount.

"The potential to translate these findings to tailor postoperative prescribing to patient needs and change national practice is high," a coauthor said in a statement. "This study has national implications, as it shows that patients only take a fraction of the amounts that we know are prescribed on average across the country."

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