Accuracy of self-reported opioid use in orthopaedic trauma patients

Purpose Opioids have long been a mainstay of treatment for pain in patients with orthopaedic injuries, but little is known about the accuracy of self-reported narcotic usage in orthopaedic trauma. The purpose of this study is to evaluate the accuracy of self-reported opioid usage in orthopaedic trauma patients. Methods A retrospective review of all new patients presenting to the orthopaedic trauma clinic of a level 1 trauma centre with a chief complaint of recent orthopaedic-related injury over a 2-year time frame was conducted. Participants were administered a survey inquiring about narcotic usage within the prior 3 months. Responses were cross-referenced against a query of a statewide prescription drug monitoring program system. Results The study comprised 241 participants; 206 (85.5%) were accurate reporters, while 35 (14.5%) were inaccurate reporters. Significantly increased accuracy was associated with hospital admission prior to clinic visit (beta = - 1.33; chi(2) = 10.68, P < 0.01; OR: 0.07, 95% CI 0.01-0.62). Decreased accuracy was associated with higher pre-visit total morphine equivalent dose (MED) (beta = 0.002; chi(2) = 11.30, P < 0.01), with accurate reporters having significantly lower pre-index visit MED levels compared to underreporters (89.2 +/- 208.7 mg vs. 249.6 +/- 509.3 mg; P = 0.04). An Emergency Department (ED) visit prior to the index visit significantly predicted underreporting (beta = 0.424; chi(2) = 4.28, P = 0.04; OR: 2.34, 95% CI 1.01-5.38). Conclusion This study suggests that most new patients presenting to an orthopaedic trauma clinic with acute injury will accurately report their narcotic usage within the preceding 3 months. Prior hospital admissions increased the likelihood of accurate reporting while higher MEDs or an ED visit prior to the initial visit increased the likelihood of underreporting.

Automated summary

This study aimed to evaluate the accuracy of self-reported opioid usage in orthopaedic trauma patients. The results showed that most patients accurately reported their narcotic usage within the preceding 3 months. Hospital admissions and lower medication doses were associated with increased accuracy, while higher medication doses or an emergency department visit prior to the initial visit were associated with underreporting.