Analysis of Opioid Prescribing Trends Following Thyroidectomy and Parathyroidectomy Before and After the 2021 American Academy of Otolaryngology–Head and Neck Surgery Opioid Prescribing Clinical Practice Guidelines

Objective: To evaluate the trends in opioid and nonopioid prescribing for thyroidectomy and parathyroidectomy before and after the publication of guidelines by the American Academy of Otolaryngology–Head and Neck Surgery in April 2021. Study Design: Retrospective. Setting: Eighty-three health care organizations in the United States that contribute to the TriNetX database. Methods: Deidentified patient data were retrieved from the TriNetX. Patients who were prescribed either opioids or nonopioid analgesic within 1 to 5 days following thyroid surgery and parathyroidectomy were included. Evaluation of the prescription trends was performed by interrupted time series analysis in Statistical Analysis System 9.4 with significance set at P <.05 to assess trends before and after the new opioid prescription guidelines. Results: For thyroid surgery, there was an immediate effect of the guideline change indicated by a 3.3% decrease in the opioid prescription trend (P =.03) and a significant increase in nonopioid use of overtime by 0.13% every 3 months (P <.0001). The opioid prescription trend following parathyroidectomy significantly decreased over time by 0.28% every 3 months (P <.0001), while the nonopioid prescription trend increased by 0.14% (P <.0001). Conclusion: There was an associated immediate reduction in the opioid prescribing trend for thyroidectomy, but the change was not sustained overtime. There was an associated decrease in the opioid prescribing trend for parathyroidectomy, but not immediately after the initial publication of the prescription guidelines. Level of Evidence: Level III.