Nguyen L, Bowlds S, Munford C, Miller K, Finnegan T, Clayton E, Behara MR, Senkowski C. Decreasing Postoperative Opioid Prescribing through Education.
JOURNAL OF SURGICAL EDUCATION 2020;
77:615-620. [PMID:
31859229 DOI:
10.1016/j.jsurg.2019.11.010]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 09/28/2019] [Accepted: 11/23/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES
To study how an educational intervention given to surgical residents affected postoperative opioid prescribing. To determine whether decreased opioid prescription amounts increased patients' rate of refills, emergency department visits, or readmissions.
DESIGN
Prospective sequential cohort study.
SETTING
Level 1 tertiary care center in Savannah, Georgia.
PARTICIPANTS
Opioid-naive patients who underwent general surgery (appendectomy, cholecystectomy, colectomy, hernia repair, lumpectomy, and mastectomy) between November 2017 and February 2018.
RESULTS
Over a 6 month period, morphine milligram equivalents (MME) prescribed after general surgery per patient was decreased by 21.8% on average, with the largest reductions seen after breast and gallbladder surgeries (38% and 25% respectively). Patients who underwent laparoscopic surgery were prescribed 18.3% fewer MME. There was no significant change in MME prescribed after open abdominal surgery. Smaller prescription amounts were not associated with an increased rate of opioid refills. There was no increase in pain-related calls to clinic offices, emergency department visits, or readmissions for pain.
CONCLUSION
After a single education intervention given to surgical residents, MME prescribed after common general surgeries can be decreased significantly without increasing rates of refills or utilization of care.
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