{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:35:07Z","timestamp":1787754907185,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,10,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although orthopaedic surgeons have been shown to prescribe excessive amounts of opioid analgesics postoperatively, the degree in which surgical trainees contribute to this trend is unknown. The purpose of this study was to compare self-reported opioid-prescribing behavior, factors influencing this behavior, and perceptions of patient opioid utilization and disposal between hand surgeons and trainees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Attending hand surgeons and trainees in hand, orthopaedic, and plastic surgery programs were invited to participate in a web-based survey including demographic characteristics; self-reported prescribing behavior specific to 4 procedures: open carpal tunnel release, trigger finger release, thumb carpometacarpal arthroplasty, and distal radial fracture open reduction and internal fixation; and perceptions and influencing factors. Analgesic medications were converted to morphine milligram equivalents and were compared across groups of interest using independent t tests or analysis of variance for each procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 1,300 respondents (266 attending surgeons, 98 fellows, 708 orthopaedic residents, and 228 plastic surgery residents) were included. Surgeons reported prescribing fewer total morphine milligram equivalents compared with residents for all 4 procedures. Personal experience was the most influential factor for prescribing behavior by surgeons and fellows. Although residents reported that attending surgeon preference was their greatest influence, most reported no direct opioid-related communication with attending surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Residents self-report prescribing significantly higher morphine milligram equivalents for postoperative analgesia following commonly performed hand and wrist surgical procedures than attending surgeons. Poor communication between residents and attending surgeons may contribute to this finding. Residents may benefit from education on opioid prescription, and training programs should encourage direct communication between trainees and attending surgeons.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.01163","type":"journal-article","created":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T01:07:33Z","timestamp":1538615253000},"page":"e127","source":"Crossref","is-referenced-by-count":31,"title":["Self-Reported Postoperative Opioid-Prescribing Practices Following Commonly Performed Orthopaedic Hand and Wrist Surgical Procedures"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4516-2348","authenticated-orcid":false,"given":"Michael P.","family":"Gaspar","sequence":"first","affiliation":[{"name":"Philadelphia Hand to Shoulder Center, Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"},{"name":"Darden School of Business, University of Virginia, Charlottesville, Virginia"},{"name":"Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6064-2732","authenticated-orcid":false,"given":"Emily M.","family":"Pflug","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Hospital for Joint Diseases, NYU School of Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-4021","authenticated-orcid":false,"given":"Alexander J.","family":"Adams","sequence":"additional","affiliation":[{"name":"Philadelphia Hand to Shoulder Center, Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7779-1160","authenticated-orcid":false,"given":"Sidney M.","family":"Jacoby","sequence":"additional","affiliation":[{"name":"Philadelphia Hand to Shoulder Center, Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-8608","authenticated-orcid":false,"given":"Eon K.","family":"Shin","sequence":"additional","affiliation":[{"name":"Philadelphia Hand to Shoulder Center, Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2641-7360","authenticated-orcid":false,"given":"A. Lee","family":"Osterman","sequence":"additional","affiliation":[{"name":"Philadelphia Hand to Shoulder Center, Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1400-7874","authenticated-orcid":false,"given":"Patrick M.","family":"Kane","sequence":"additional","affiliation":[{"name":"Philadelphia Hand to Shoulder Center, Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,10,3]]},"reference":[{"issue":"16","key":"bib1-20230810","first-page":"1573","article-title":"Trends in opioid analgesic abuse and mortality in the United States","volume":"372","author":"Dart","year":"2015","journal-title":"N Engl J Med."},{"issue":"15","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1056\/NEJMsr1601307","article-title":"A proactive response to prescription opioid abuse","volume":"374","author":"Califf","year":"2016","journal-title":"N Engl J Med."},{"issue":"5051","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.15585\/mmwr.mm655051e1","article-title":"Increases in drug and opioid-involved overdose deaths - United States, 2010-2015","volume":"65","author":"Rudd","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"1","key":"bib4-20230810","first-page":"52","article-title":"SCOPE of pain: an evaluation of an opioid risk evaluation and mitigation strategy continuing education program","volume":"17","author":"Alford","year":"2016","journal-title":"Pain Med."},{"issue":"16","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1056\/NEJMp1515917","article-title":"Reducing the risks of relief\u2014the CDC opioid-prescribing guideline","volume":"374","author":"Frieden","year":"2016","journal-title":"N Engl J Med."},{"issue":"22","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1056\/NEJMp1402780","article-title":"Medication-assisted therapies\u2014tackling the opioid-overdose epidemic","volume":"370","author":"Volkow","year":"2014","journal-title":"N Engl J Med."},{"issue":"4","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1377\/hlthaff.2016.1141","article-title":"States with prescription drug monitoring mandates saw a reduction in opioids prescribed to Medicaid enrollees","volume":"36","author":"Wen","year":"2017","journal-title":"Health Aff (Millwood)."},{"issue":"2","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jpain.2015.10.023","article-title":"Research gaps in practice guidelines for acute postoperative pain management in adults: findings from a review of the evidence for an American Pain Society clinical practice guideline","volume":"17","author":"Gordon","year":"2016","journal-title":"J Pain."},{"issue":"6","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"e170504","DOI":"10.1001\/jamasurg.2017.0504","article-title":"New persistent opioid use after minor and major surgical procedures in US adults","volume":"152","author":"Brummett","year":"2017","journal-title":"JAMA Surg."},{"issue":"10","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/j.jhsa.2016.07.113","article-title":"Risk of prolonged opioid use among opioid-na\u00efve patients following common hand surgery procedures","volume":"41","author":"Johnson","year":"2016","journal-title":"J Hand Surg Am."},{"issue":"10","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"265","DOI":"10.15585\/mmwr.mm6610a1","article-title":"Characteristics of initial prescription episodes and likelihood of long-term opioid use - United States, 2006-2015","volume":"66","author":"Shah","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"2","key":"bib12-20230810","doi-asserted-by":"crossref","first-page":"355e","DOI":"10.1097\/01.prs.0000475788.52446.7b","article-title":"The use of opioid analgesics following common upper extremity surgical procedures: a national, population-based study","volume":"137","author":"Waljee","year":"2016","journal-title":"Plast Reconstr Surg."},{"issue":"20","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.2106\/JBJS.15.00614","article-title":"A prospective evaluation of opioid utilization after upper-extremity surgical procedures: identifying consumption patterns and determining prescribing guidelines","volume":"98","author":"Kim","year":"2016","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.jhsa.2012.01.035","article-title":"Opioid consumption following outpatient upper extremity surgery","volume":"37","author":"Rodgers","year":"2012","journal-title":"J Hand Surg Am."},{"issue":"3","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1177\/0363546517693665","article-title":"Unused opioid pills after outpatient shoulder surgeries given current perioperative prescribing habits","volume":"45","author":"Kumar","year":"2017","journal-title":"Am J Sports Med."},{"issue":"4","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.jmig.2017.11.005","article-title":"Opioid prescription and patient use after gynecologic procedures: a survey of patients and providers","volume":"25","author":"Griffith","year":"2018","journal-title":"J Minim Invasive Gynecol."},{"issue":"1","key":"bib17-20230810","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/AOG.0000000000002093","article-title":"Patterns of opioid prescription and use after cesarean delivery","volume":"130","author":"Bateman","year":"2017","journal-title":"Obstet Gynecol."},{"issue":"2","key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.juro.2010.09.088","article-title":"Overprescription of postoperative narcotics: a look at postoperative pain medication delivery, consumption and disposal in urological practice","volume":"185","author":"Bates","year":"2011","journal-title":"J Urol."},{"issue":"6","key":"bib19-20230810","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1097\/SLA.0000000000002591","article-title":"Best Practice in Surgery Group. Opioid use after discharge in postoperative patients: a systematic review","volume":"267","author":"Feinberg","year":"2018","journal-title":"Ann Surg."},{"key":"bib20-20230810","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.drugalcdep.2016.08.016","article-title":"Unused opioid analgesics and drug disposal following outpatient dental surgery: a randomized controlled trial","volume":"168","author":"Maughan","year":"2016","journal-title":"Drug Alcohol Depend."},{"issue":"4","key":"bib21-20230810","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1097\/SLA.0000000000001993","article-title":"Wide variation and excessive dosage of opioid prescriptions for common general surgical procedures","volume":"265","author":"Hill","year":"2017","journal-title":"Ann Surg."},{"issue":"3","key":"bib23-20230810","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1177\/1558944715627631","article-title":"Geographic and age-based variations in Medicare reimbursement among ASSH members","volume":"11","author":"Gaspar","year":"2016","journal-title":"Hand (N Y)."},{"issue":"21","key":"bib24-20230810","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1001\/jama.2016.13513","article-title":"Graduate medical education, 2015-2016","volume":"316","author":"Brotherton","year":"2016","journal-title":"JAMA."},{"issue":"5","key":"bib26-20230810","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.2106\/JBJS.J.00489","article-title":"Career plans of current orthopaedic residents with a focus on sex-based and generational differences","volume":"93","author":"Hariri","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"5","key":"bib27-20230810","doi-asserted-by":"crossref","first-page":"293","DOI":"10.7326\/M17-0865","article-title":"Prescription opioid use, misuse, and use disorders in U.S. adults: 2015 national survey on drug use and health","volume":"167","author":"Han","year":"2017","journal-title":"Ann Intern Med."},{"issue":"1","key":"bib28-20230810","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1080\/10826084.2017.1323928","article-title":"Opioid prescribing patterns by obstetrics and gynecology residents in the United States","volume":"53","author":"Baruch","year":"2018","journal-title":"Subst Use Misuse."},{"issue":"1","key":"bib29-20230810","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jsurg.2017.06.020","article-title":"Trainees as agents of change in the opioid epidemic: optimizing the opioid prescription practices of surgical residents","volume":"75","author":"Chiu","year":"2018","journal-title":"J Surg Educ."},{"issue":"4","key":"bib30-20230810","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1177\/1558944717717506","article-title":"Surgeon preference, influence, and treatment of thumb carpometacarpal arthritis","volume":"13","author":"Deutch","year":"2018","journal-title":"Hand (N Y)."},{"issue":"1","key":"bib31-20230810","doi-asserted-by":"crossref","first-page":"e0147972","DOI":"10.1371\/journal.pone.0147972","article-title":"Opioid use and storage patterns by patients after hospital discharge following surgery","volume":"11","author":"Bartels","year":"2016","journal-title":"PLoS One."},{"issue":"15","key":"bib32-20230810","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.1001\/jama.2016.0130","article-title":"Opioids prescribed after low-risk surgical procedures in the United States, 2004-2012","volume":"315","author":"Wunsch","year":"2016","journal-title":"JAMA."},{"issue":"1","key":"bib33-20230810","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.amjsurg.2017.10.035","article-title":"Variation in post-discharge opioid prescriptions among members of a surgical team","volume":"216","author":"Blay","year":"2018","journal-title":"Am J Surg."},{"issue":"3","key":"bib34-20230810","doi-asserted-by":"crossref","first-page":"153","DOI":"10.5055\/jom.2012.0111","article-title":"Long-term opioid therapy, aberrant behaviors, and substance misuse: comparison of patients treated by resident and attending physicians in a general medical clinic","volume":"8","author":"Colburn","year":"2012","journal-title":"J Opioid Manag."},{"issue":"3","key":"bib35-20230810","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/pme.12602","article-title":"Adherence to prescription opioid monitoring guidelines among residents and attending physicians in the primary care setting","volume":"16","author":"Khalid","year":"2015","journal-title":"Pain Med."},{"issue":"2","key":"bib36-20230810","doi-asserted-by":"crossref","first-page":"138","DOI":"10.4300\/JGME-D-15-00186.1","article-title":"Resident decision making: opioids in the outpatient setting","volume":"8","author":"Siegler","year":"2016","journal-title":"J Grad Med Educ."},{"issue":"2","key":"bib37-20230810","doi-asserted-by":"crossref","first-page":"260","DOI":"10.4300\/JGME-D-10-00006.1","article-title":"Preparation, confidence, and attitudes about chronic noncancer pain in graduate medical education","volume":"2","author":"Yanni","year":"2010","journal-title":"J Grad Med Educ."},{"issue":"2","key":"bib38-20230810","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.jhsa.2014.10.054","article-title":"The effect of an educational program on opioid prescription patterns in hand surgery: a quality improvement program","volume":"40","author":"Stanek","year":"2015","journal-title":"J Hand Surg Am."},{"issue":"3","key":"bib39-20230810","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1097\/SLA.0000000000002198","article-title":"An educational intervention decreases opioid prescribing after general surgical operations","volume":"267","author":"Hill","year":"2018","journal-title":"Ann Surg."},{"issue":"8","key":"bib40-20230810","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1046\/j.1525-1497.2002.10837.x","article-title":"Can a pain management and palliative care curriculum improve the opioid prescribing practices of medical residents?","volume":"17","author":"Ury","year":"2002","journal-title":"J Gen Intern Med."},{"issue":"6","key":"bib41-20230810","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1111\/jcpt.12444","article-title":"The Centers for Disease Control and Prevention opioid guidelines: potential for unintended consequences and will they be abused?","volume":"41","author":"Pergolizzi","year":"2016","journal-title":"J Clin Pharm Ther."},{"issue":"3","key":"bib42-20230810","doi-asserted-by":"crossref","first-page":"660","DOI":"10.2106\/00004623-200603000-00027","article-title":"American Board of Orthopaedic Surgery Practice of the Orthopaedic Surgeon: Part-II, certification examination case mix","volume":"88","author":"Garrett","year":"2006","journal-title":"J Bone Joint Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201810030-00013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:34:45Z","timestamp":1787751285000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201810030-00013"}},"subtitle":["A Nationwide Survey Comparing Attending Surgeons and Trainees"],"short-title":[],"issued":{"date-parts":[[2018,10,3]]},"references-count":40,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.17.01163","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,3]]}}}