Septoplasty opioid prescription trends following the publication of opioid prescribing clinical practice guidelines

Background: To address rising opioid prescriptions, more institutions have implemented prescribing guidelines emphasizing non-opioid and other multimodal pain control. In April 2021, the AAO-HNS released guidelines for common otolaryngologic procedures to improve patient safety, reduce unnecessary opioid use, and lower the risk of postsurgical opioid dependence. The goal of this study is to evaluate the trends in opioid and non-opioid prescribing for septoplasty in relation to the publication of a major clinical practice guideline by the AAO-HNS in April 2021. Methods: This multicenter retrospective study analyzes de-identified patient data from the TriNetX database, focusing on individuals prescribed either opioid or non-opioid analgesics within 1–5 days following septoplasty from January 1, 2013 to December 31, 2023. Interrupted time series analysis in Statistical Analysis System (SAS) 9.4 was performed with significant set at p < 0.05 to evaluate the changes in prescribing trends. Results: Immediately, the opioid prescribing increased for septoplasty by 1.41 %, but it was not statistically significant (p = 0.08). After the initial change, there was an overall statistically significant decrease in opioid prescribing by 0.24 % every 3 months (p < 0.0001). For non-opioid prescriptions, a significant decrease occurred immediately by −0.53 % (p < 0.0001), but a long-term significant slow increase in prescribing by 0.03 % was identified every 3 months (p < 0.0001). The rate of opioid prescribing did not differ before and after guideline publication (p = 0.58), while non-opioid prescribing rate was significantly higher afterward (p = 0.03). Conclusions: There was an associated decrease in opioid prescribing for septoplasty post-publication. However, this decrease was not observed immediately after the guideline publication, and rate of change before and after the publication was similar. Non-opioid prescription did not have an immediate increase, but the trend gradually increased in the post-publication period. This was a significant change from the pre-publication period.