Out of 358,012 total patients undergoing Mohs micrographic surgery, the proportion receiving opioid prescriptions within 2 days of the procedure was 34.6% in 2009, which increased to 39.6% in 2011 and subsequently decreased to 11.7% in 2020.
Clinical Pearls
This cross-sectional study used a nationally representative insurance claims database to analyze the proportion of patients receiving opioid prescriptions within 2 days of Mohs micrographic surgery from 2009 to 2020.
Out of 358,012 total patients undergoing Mohs micrographic surgery, the proportion receiving opioid prescriptions within 2 days of the procedure was 34.6% in 2009, which increased to 39.6% in 2011 and subsequently decreased to 11.7% in 2020.
Hydrocodone, Codeine, Oxycodone, and Tramadol were found to be the 4 most commonly prescribed opioids. The use of Hydrocodone decreased, and the use of Tramadol increased from 2009 to 2020.
Discussion:
The use of opioids by dermatologic surgeons is mostly limited to short courses lasting less than a week. However, even courses as short as these can increase risk of addiction and abuse of these drugs. This study sought to better understand how the use of opioids by dermatologic surgeons has evolved from 2009 to 2020.
In this cross-sectional study, the Optum Clinformatics Data Mart, a de-identified insurance claims database, was used to evaluate claims for skin cancer treated in the United States from January 1, 2009, to June 1, 2020. Only patients 18 years or older and with a claim for Mohs micrographic surgery were included in the study and those who had an associated pharmaceutical claim for an opioid within 2 days of the Mohs micrographic surgery claim were counted as having a dermatologic surgery-associated opioid prescription.
The authors found that from 2009 to 2020, the database used included 358,012 claims for Mohs micrographic surgery and 93,046 (26%) of those had an associated opioid claim. The percentage of Mohs micrographic surgery claims with an associated opioid claim in 2009 was 34.6%, which subsequently peaked at 39.6% in 2011, and decreased annually to a rate of 11.7% in 2020. The mean number of days of opioids supplied from 2009 to 2020 was 4.0 and the four most common opioids prescribed were Hydrocodone (55%), Codeine (16.3%), Oxycodone (12%), and Tramadol (11.6%). The use of Hydrocodone decreased and the use of Tramadol increased from 2009 to 2020. One limitation of this study is the fact that it analyzed opioid claims, and thus could not account for unfilled opioid prescriptions, opioids not taken, or opioids obtained without a prescription.
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