Background and Aims Medication assisted treatment (MAT) with long acting opioid agonists is the gold standard treatment for patients with opioid use disorder. ¹ The incidence of patients on buprenorphineundergoing orthopedic surgeries has not been described. We use a national dataset to report trends in buprenorphine utilization prior to orthopedic surgeries and resumption of buprenorphine following orthopedic surgery.

Methods This study was approved by the institutional review board of the Hospital for Special surgery (IRB#2017–0169). Using the Truven MarketScan database we identified adult patients undergoing elective orthopedic surgeries and who had filled a prescription for buprenorphine within180 days prior to surgery. Patients who filled a prescription for buprenorphine within 180 days following surgery were defined as having restarted MAT. Trends were evaluated using Cochran-Armitage Trend Tests.

Results Among 262,579 patients included between the years 2015 and 2019, 0.45% filled a prescription for buprenorphine prior to surgery. The proportion of patients restarted on buprenorphine increased from 46.9% to 63.6% between 2015 and 2019 (Figure 1; p<.001). In the patients who received buprenorphine following surgery, 248 (37.7%) had a chronic prescription for short-term opioids compared with 298 (55.1%) of the patients who were not restarted on buprenorphine following surgery (Table 1. p<.001).

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Abstract B369 Figure 1

Conclusions The proportion of patients that were restarted on buprenorphine within 180 days following surgery increased over time. Patients who were restarted on buprenorphine following surgery chronically filled prescription for short acting opioids less commonly compared to patients who were not restarted.