Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Opioids and the Dermatology Medicare Population

JAMA Dermatology; ePub 2018 Feb 7; Cao, et al

Opioid prescribing among dermatologists is limited and concentrated in the surgical setting, but it may be associated with a substantial number of adverse events that serve as a reminder to emphasize non-opioid pain medications in the postoperative setting. This according to a recent cross-sectional study that evaluated opioid prescriptions by dermatologists to Medicare beneficiaries from January 1 to December 31, 2014. A systematic literature review was conducted to estimate the outcome of opioid prescribing practices on the exposed population. Investigators found:

  • Of the 12,537 dermatologists in the study, 5,305 (42.3%) prescribed no opioid claims, 5,408 (43.1%) prescribed 1 to 10 opioid claims, and 1,824 (14.5%) prescribed >10 opioid claims.
  • A total of 108 dermatologists (93.9%) in the top 1% of opioid prescribers (n=115) work in a surgical practice.
  • Estimates suggest that opioids prescribed by dermatologists could annually lead to 3,877 to 7,602 beneficiaries continuing to use opioids at 1 year and 1,825 to 4,209 continuing to use opioids at 3 years.

Cao S, Karmouta R, Li DG, Din RS, Mostaghimi A. Opioid prescribing patterns and complications in the dermatology Medicare population. [Published online ahead of print February 7, 2018]. JAMA Dermatology. doi:10.1001/jamadermatol.2017.5835.

This Week's Must Reads

HLA Antigen Mismatch Linked with Skin Cancer Risk, JAMA Dermatology; ePub 2019 Jan 23; Gao, Twigg, et al

Poor Prognosis for Thin Ulcerated Melanomas Found, J Am Acad Dermatol; ePub 2019 Jan 14; Hawkins, et al

Association Between AD and Mental Health Disorders, Dermatitis; ePub 2018 Dec 18; Hsu, Smith, et al

Nonsterile Gloves Safe for Skin Cancer Excisions, J Cosmet Dermatol; ePub 2019 Jan 20; Michener, et al

Adult Atopic Dermatitis Profile Varies with Age, J Allergy Clin Immunol; ePub 2019 Jan 24; Zhou, et al

Must Reads in Dermatologic Surgery

Nonsterile Gloves Safe for Skin Cancer Excisions, J Cosmet Dermatol; ePub 2019 Jan 20; Michener, et al

Patient Communication Assessed Post-Mohs Surgery, Dermatolog Surg; ePub 2019 Jan 11; Chitgopeker, et al

Mohs Surgery Beneficial for Melanoma of Head/Neck, Dermatolog Surg; ePub 2018 Dec 13; Demer, et al

DOT Laser Offers Low Incidence of Adverse Effects, J Drugs Dermatol; 2018 Nov; Sarnoff, Gotkin, et al

Study: More Than 85% of Surgeons Use Skin Hooks, Dermatolog Surg; ePub 2018 Oct 9; Clark, et al