Opioid prescription patterns for hidradenitis suppurativa in the emergency versus ambulatory care settings

Abstract

Abstract Hidradenitis suppurativa (HS) is associated with significant pain. However, there is a paucity of literature examining opioid prescription patterns in HS in different healthcare settings. We aim to determine differences in opioid prescription patterns between HS patients managed in the Emergency Department (ED) and ambulatory care settings. We conducted a cross-sectional study using the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) databases to determine opioid prescription rates among HS patient visits conducted in the ED and ambulatory care settings between 2006-2016 and 2018-2019. A weighted total of 2,923,059 HS patient visits were identified. The most prescribed opioids among HS patient visits were oxycodone (51.3%) and hydrocodone (35.7%). Patients seeking care in the ED were significantly more likely to receive an opioid prescription than those in the ambulatory care setting (OR 5.24;95%CI 1.32-20.80;p=0.019). The results were adjusted for confounding variables. Opioids were over five times more likely to be prescribed among HS visits in the ED than the ambulatory care setting. This could potentially be attributed to patients with acute flares, which are characterized by severe pain requiring analgesia, presenting to the ED over the ambulatory setting. Our findings emphasize the importance of connecting HS patients with regular follow-up care to increase disease control and decrease painful flares that result in presentation to the ED.