Impact of policy-based and institutional interventions on postoperative opioid prescribing practices - 16/09/21
Abstract |
Background |
We assessed the impact of policy-based and institutional interventions to limit postoperative opioid prescribing.
Methods |
Retrospective cohort study of patients who underwent laparoscopic/open appendectomies, laparoscopic/open cholecystectomies, and laparoscopic/open inguinal hernia repair during a 6-month interval in 2018 (control), 2019 (post-policy intervention), and 2020 (post-institutional intervention) to assess changes in postoperative opioid prescribing patterns. A survey was collected for the 2020 cohort.
Results |
Comparing the 762 patients identified in 2018, 2019, and 2020 cohorts there was a significant decrease in mean opioid tabs prescribed (23.5 ± 8.9 vs. 16.2 ± 7.0 vs. 12.8 ± 4.9, p < 0.01) and mean OME dosage (148.0 ± 68.0 vs. 108.6 ± 51.8 vs. 95.4 ± 38.0, p < 0.01), without a difference in refill requests. Patient survey (response rate 63%) indicated 91.4% of patients reported sufficient pain control.
Conclusion |
Formalized opioid-prescribing guidelines and statewide regulations can significantly decrease postoperative opioid prescribing with good patient satisfaction. Surgeon education may facilitate efforts to minimize narcotic over-prescription without compromising pain management.
Le texte complet de cet article est disponible en PDF.Highlights |
• | State-level opioid prescribing policies with subsequent institutional intervention resulted in reduction opioids prescribed. |
• | There was an increase in the in use of non-opioid pain adjuncts (i.e. acetaminophen and NSAIDs). |
• | The majority of patients surveyed had leftover opioids and indicated that they had minimal opioid disposal knowledge. |
• | Efforts to address the opioid epidemic can be furthered by patient education and interventions limiting opioids prescribed. |
Keywords : Opioids, Surgery, Prescribing practices, Post-operative pain management
Plan
Vol 222 - N° 4
P. 766-772 - octobre 2021 Retour au numéro
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