Tackling the opioid epidemic: Reducing opioid prescribing while maintaining patient satisfaction with pain management after outpatient surgery.
Adolescent
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures
Analgesics, Opioid
/ pharmacology
Drug Prescriptions
/ statistics & numerical data
Female
Humans
Male
Middle Aged
Opioid Epidemic
/ statistics & numerical data
Pain Management
/ methods
Pain, Postoperative
/ drug therapy
Patient Satisfaction
Practice Patterns, Physicians'
Quality Improvement
Retrospective Studies
Surveys and Questionnaires
Young Adult
Opioids
Prescribing
Quality improvement
Surgery
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
14
11
2019
revised:
03
03
2020
accepted:
07
04
2020
pubmed:
16
5
2020
medline:
24
11
2020
entrez:
16
5
2020
Statut:
ppublish
Résumé
Results of a quality improvement (QI) project to standardize our opioid prescribing practices following five common outpatient general surgery procedures are presented. Opioid prescribing habits were reviewed from June to December 2017. QI measures were implemented. We prospectively collected data on opioid prescribing habits and patients' pain management ratings from September 2018 to February 2019. Following implementation, combination pills were less prescribed. More patients were prescribed adjuncts pre- (66% vs. 3%; p < 0.01) and post-operatively (85% vs. 50%; p < 0.01). One-third of pills were prescribed (1363 vs. 4185), with only 520 consumed. Average OME prescribed decreased from 179 to 127 mg (p < 0.001). At follow-up, 52 patients (54%) reported taking 11 pills (1-20) post-operatively for five days. Pain management was rated as good/excellent (88.6%) or fair (9.3%). Using a pragmatic multimodal approach, decreasing opioid prescriptions at discharge allows for adequate pain management.
Identifiants
pubmed: 32409011
pii: S0002-9610(20)30210-5
doi: 10.1016/j.amjsurg.2020.04.006
pmc: PMC7709892
mid: NIHMS1612331
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1108-1114Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR002537
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors have no conflict of interest to declare.
Références
JAMA Surg. 2018 Nov 1;153(11):1012-1019
pubmed: 30027289
Patient Educ Couns. 2019 Feb;102(2):383-387
pubmed: 30219634
Pain Rep. 2018 Feb 06;3(1):e637
pubmed: 29430565
Am J Surg. 2019 Jun;217(6):1116-1120
pubmed: 30528821
J Am Coll Surg. 2018 Aug;227(2):203-211
pubmed: 29746919
Br J Anaesth. 2011 Apr;106(4):454-62
pubmed: 21357616
JAMA Surg. 2017 Jun 21;152(6):e170504
pubmed: 28403427
Pain Physician. 2016 Jul;19(6):349-56
pubmed: 27454264
J Pain Res. 2016 Sep 12;9:631-40
pubmed: 27672340
Am J Surg. 2019 Feb;217(2):228-232
pubmed: 30180937
Ann Surg. 2017 Apr;265(4):709-714
pubmed: 27631771
J Foot Ankle Surg. 2018 Jul - Aug;57(4):781-784
pubmed: 29748103
Pain. 2015 Apr;156(4):569-76
pubmed: 25785523
JAMA Surg. 2019 Nov 1;154(11):1049-1054
pubmed: 31617880
J Surg Educ. 2018 Jan - Feb;75(1):65-71
pubmed: 28705485
Surgery. 2018 Nov;164(5):926-930
pubmed: 30049481
Acta Anaesthesiol Scand. 2016 Oct;60(9):1188-208
pubmed: 27426431