The opioid epidemic and patient satisfaction: A review of one institution's experience

Background: The opioid crisis caused the Drug Enforcement Administration (DEA) to reschedule hydrocodone to schedule II from III. Other narcotics (i.e. codeine) were not reclassified, becoming the narcotic medications for many surgeons. We wanted to review how this rescheduling of hydrocodone influenced prescribing practices and Press Ganey scores. Methods: A retrospective review from April 6, 2014, to April 5, 2015, was conducted on all orthopaedic trauma patients at a level I trauma center. Patient charts were abstracted for the type and amount of narcotic prescribed. Press Ganey scores for the surgeons were collected during the same period. The data were used to determine the percentage of hydrocodone prescription before and after reclassification as well as the effect on Press Ganey Scores. Results: Surgeons significantly decreased the percentage of hydrocodone prescriptions, 70% versus 44% (P < 0.001), after reclassification. Two surgeons, A (76% vs. 11%) and B (69% vs. 30%), had a significant decrease in the percentage of hydrocodone (P < 0.0001), surgeon C's percentage (67% vs. 67%) did not change (P =0.96), and surgeon D significantly increased (67% vs. 86%) (P =0.009). No significant changes were seen for overall Press Ganey scores for the group aggregate or individual providers, 91 versus 91 (P =0.993) after reclassification. Conclusions: The results show that the percentage of hydrocodone to all narcotic prescriptions decreased after rescheduling hydrocodone. This did vary by individual surgeon, with one surgeon's percentage being significantly increased. Press Ganey scores did not appear to be influenced by rescheduling hydrocodone.