Evaluation of Opioid Prescribing Guidelines on Opioid Prescription Trends for Parotidectomy

Objective: To evaluate the trends in opioid and non-opioid prescribing for parotidectomy in relation to the publication of opioid prescribing guidelines by the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) in April 2021. Study Design: Retrospective. Setting: Eighty healthcare organizations in the United States. Methods: The TriNetX database was used to obtain deidentified patient data from January 1, 2013, to December 31, 2023. Patients who received a prescription for either opioid or non-opioid analgesics within 1 to 5 days after parotidectomy were included. Prescription trends were analyzed using interrupted time series analysis in Statistical Analysis System (SAS) 9.4, with significance defined as P <.05, to assess changes in relation to the implementation of the AAO-HNS guidelines. Results: Opioid prescribing had an immediate significant decrease by 7.44% (P <.0001). The trend was sustained and continued to significantly decrease by 0.20% every 3 months (P =.001). Non-opioid prescribing in the initial period following the guideline publication increased significantly by 3.73% (P <.0001). The trend continued to significantly increase by 0.12% every 3 months (P <.0001). Conclusion: An immediate reduction in opioid prescribing was identified for parotidectomy, and this change was sustained. Conversely, non-opioid prescribing had an associated immediate increase initially following the guideline publication, and this was also sustained.