Opioid and Non-Opioid Prescribing Rates for Ankle Fractures in Emergency Departments Across the United States Between 2006 and 2015

Context: An ankle fracture is a common injury observed in the Emergency Department (ED) and is often treated conservatively or surgically, depending on whether the fracture is stable. Opioids provide value for the management of acute musculoskeletal pain. However, prolong opioid use is associated with well-known consequences in the United States such as dependence, abuse and/or misuse. Considering these concerns and the effectiveness of non-pharmacological interventions for the treatment of acute pain, it is critical to identify the prescribing patterns for patients diagnosed with an ankle fracture in the ED. Objective: Describe the percentage of patients prescribed a scheduled and non-controlled medication in the ED. Methods: This was a secondary analysis of the publicly available data collected through the National Hospital Ambulatory Medical Care Survey from 2006-2015. Data analyzed using the sampled visit weight, yielding an unbiased national estimate of ED percentages. Due to the complex sample design, sampling errors were determined using SAS software. Results: From 2006-2015, 86.9% of patients presenting with an ankle fracture received medication during their ED visit. Among those prescribed a medication, 63.02% were prescribed a controlled substance and 34.29% were prescribed a non-controlled substance. The majority of the controlled substances were given to patients between the ages of 25-64. Conclusion: Approximately 2 out of 3 patients diagnosed with an ankle fracture in the ED received a controlled substance. The majority of these given to young-adults. Other effective non-pharmacological interventions should be explored to prevent the risk of the well-known consequences associated with opioid use. Word Count: 25