Objective:

To investigate the association between discharge opioid prescribing patterns and opioid refill rates within 90 days of discharge after inpatient otolaryngology–head and neck surgery, highlighting the significance of addressing opioid management in postoperative care.

Key Findings:

• 25.3% of patients received an opioid refill within 30 days of discharge, indicating a persistent issue in opioid management despite reduced prescribing. 13.7% received a refill at 31 to 60 days, and 13.0% at 61 to 90 days. Discharge opioid underprescription and overprescription were both associated with higher refill risks, emphasizing the need for careful prescribing.

Interpretation:

Mismatch between discharge opioid doses and inpatient use significantly influenced refill rates, indicating the need for better alignment in prescribing practices to improve patient outcomes.

Limitations:

• Refill occurrence was assessed rather than the quantity of opioids dispensed or consumed, which may not reflect the true exposure to opioids. Refills prescribed by non-surgical team clinicians were not captured. The cohort was limited to patients with at least 24 hours of hospitalization, affecting generalizability. Observational design limits causal inference, highlighting the need for prospective studies.

Conclusion:

Aligning discharge opioid prescriptions with inpatient opioid use may effectively reduce postoperative refill rates, underscoring the importance of tailored opioid management strategies.