Postoperative Opioid Prescribing Patterns in Women Undergoing Mid-Urethral Sling Placement [37F

Abstract

INTRODUCTION: Mid-urethral slings are currently the most common surgery performed for stress urinary incontinence, however, no benchmarks exist to inform providers on appropriate opioid prescribing for this procedure. METHODS: Using MarketScan Commercial Claims and Encounters Database from Truven Health Analytics, we extracted all outpatient claims from 2005 through 2016 that identified women ≥ 18 years who underwent sling placement for stress incontinence using CPT codes. From this cohort, we determined whether the procedure was isolated or done concomitantly with other procedures. Patients were classified as having filled a prescription for an opioid perioperatively if a claim for a schedule II, III or tramadol prescription was filled 28 days before or after the procedure. Oral morphine milligram equivalents (MME) were calculated for each prescription. RESULTS: A total of 153,631 women were identified using the above-mentioned criteria. Of these, 79,069 (51.5%) underwent an isolated sling procedure while 74,562 (48.5%) underwent combined procedures. 84% of the patients in our cohort had 1 or more prescriptions in the perioperative time period. The median cumulative MME prescribed for patients preoperatively with isolated and multiple procedures were 200 and 225, respectively. Postoperatively, the median cumulative MME for isolated and multiple procedures were 150 and 225, respectively. Nearly half of patients who filled an opioid prescription preoperatively filled another postoperatively. CONCLUSION: Among women undergoing isolated mid-urethral sling placement, the median cumulative MME are now described. Further research optimizing prescribing practices is needed.