(HealthDay News) — Postoperative doctor shopping occurs in about one-quarter of patients with nephrolithiasis undergoing ureteroscopy, according to research published in the September issue of The Journal of Urology.
Stephen F. Kappa, MD, from the Vanderbilt University Medical Center and Geriatric Research Education and Clinical Center in Nashville, Tenn., and colleagues conducted a retrospective review of the records of 200 consecutive patients residing in Tennessee who underwent ureteroscopy with laser lithotripsy for nephrolithiasis. Patients were categorized using the Tennessee Controlled Substances Medication Database by the number of postoperative narcotic providers. Any patient seeking more than 1 narcotic provider within 3 months of surgery was identified as having doctor shopping behavior.
The researchers found that 24% of patients were prescribed narcotics by more than one provider after surgery. Patients with multiple narcotic providers were younger, less educated, more likely to have a history of mental illness, and more likely to have undergone prior stone procedures, compared to those receiving narcotics from a single provider. In addition, more frequent preoperative narcotic use, longer postoperative narcotic use, and a higher morphine equivalent dose per prescription were seen for patients prescribed narcotics by more than one provider.
“Postoperative doctor shopping is common among patients with nephrolithiasis who require operative management,” the authors write. “Urologists should be aware of available registry data to decrease the likelihood of redundant narcotic prescribing.”
1. Kappa SF, Green EA, Miller NL, et al. Narcotic Use and Postoperative Doctor Shopping by Patients with Nephrolithiasis Requiring Operative Intervention: Implications for Patient Safety. J Urol. doi: 10.1016/j.juro.2016.03.181.