Thompson J, et al. - Herein, researchers used the Truven Health Analytics MarketScan Research Database to report opioid prescribing practices for postoperative pain at time of discharge for benign hysterectomy from 2003 to 2014. Also, they described the route of hysterectomy trends over the same time period. Data showed a substantial increase in opioid prescriptions for postoperative pain after hysterectomy, between 2003 and 2014. Although a concomitant increase in less invasive routes for hysterectomy was apparent, an increase in opioid prescriptions was also documented. Physicians must recognize that postoperative prescribing practices may contribute to chronic opioid use. The necessity of improving awareness of opioid prescribing practices at time of surgical discharge was realized in the context of working towards developing postoperative patient care plans with increased safety and efficacy.

• Researchers used the Truven Health Analytics MarketScan Research Database including the Commercial Claims and Encounters Database and the Medicare Supplemental and Coordination of Benefits Database.
• Using current Procedural Terminology (CPT4) and International Classification of Diseases 9th revision (ICD-9) codes, they identified all patients who underwent a hysterectomy for benign indication between 2003 to 2014.
• They grouped hysterectomy routes as abdominal, laparoscopic, vaginal, and other.
• They also identified the opioid type, dose, and days supplied at the time of discharge.
• Using descriptive statistics, they summarized data within the entire study period.
• Additionally, they used linear regression models to describe trends among hysterectomy route and opioid prescriptions.

• A total of 796,726 patients who underwent a hysterectomy for benign indications between 2003 and 2014 were identified; of these, 764,683 were identified from the Commercial Claims and Encounters Database and 32,043 from the Medicare Database.
• Data showed that route of hysterectomy was categorized into 40.3% abdominal, 41.8% laparoscopic, 17.4% vaginal, and 0.5% other hysterectomy during the study period.
• Researchers noted a change in the route of hysterectomy, from 60.8% to 25.5% abdominal, 17.5% to 62.4% laparoscopic, 21.2% to 11.8% vaginal, and 0.5% to 0.3% other hysterectomy, from 2003 to 2014.
• An increase from 17.0% in 2003 to 47.2% in 2014 was apparent in the percentage of patients prescribed opioids at the time of discharge for all hysterectomy routes.