Opioid Prescribing Recommendations After Mohs Micrographic Surgery and Reconstruction: A Delphi Consensus.

Adult Analgesics, Opioid / adverse effects Consensus Delphi Technique Drug Prescriptions / standards Female Humans Male Middle Aged Mohs Surgery / adverse effects Opioid Epidemic / prevention & control Opioid-Related Disorders / epidemiology Pain, Postoperative / drug therapy Practice Guidelines as Topic Practice Patterns, Physicians' / standards Skin Neoplasms / surgery Societies, Medical / standards Surgeons / standards United States

Journal

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

ISSN: 1524-4725

Titre abrégé: Dermatol Surg

Pays: United States

ID NLM: 9504371

Informations de publication

Date de publication:
01 02 2021

Historique:

pubmed: 10 8 2020

medline: 27 4 2021

entrez: 10 8 2020

Statut: ppublish

Résumé

Prescription opioids play a large role in the opioid epidemic. Even short-term prescriptions provided postoperatively can lead to dependence. To provide opioid prescription recommendations after Mohs micrographic surgery (MMS) and reconstruction. This was a multi-institutional Delphi consensus study consisting of a panel of members of the American College of Mohs Surgery from various practice settings. Participants were first asked to describe scenarios in which they prescribe opioids at various frequencies. These scenarios then underwent 2 Delphi ratings rounds that aimed to identify situations in which opioid prescriptions should, or should not, be routinely prescribed. Consensus was set at ≥80% agreement. Prescription recommendations were then distributed to the panelists for feedback and approval. Twenty-three Mohs surgeons participated in the study. There was no scenario in which consensus was met to routinely provide an opioid prescription. However, there were several scenarios in which consensus were met to not routinely prescribe an opioid. Opioids should not be routinely prescribed to every patient undergoing MMS. Prescription recommendations for opioids after MMS and reconstruction may decrease the exposure to these drugs and help combat the opioid epidemic.

Sections du résumé

BACKGROUND

Prescription opioids play a large role in the opioid epidemic. Even short-term prescriptions provided postoperatively can lead to dependence.

OBJECTIVE

To provide opioid prescription recommendations after Mohs micrographic surgery (MMS) and reconstruction.

METHODS

This was a multi-institutional Delphi consensus study consisting of a panel of members of the American College of Mohs Surgery from various practice settings. Participants were first asked to describe scenarios in which they prescribe opioids at various frequencies. These scenarios then underwent 2 Delphi ratings rounds that aimed to identify situations in which opioid prescriptions should, or should not, be routinely prescribed. Consensus was set at ≥80% agreement. Prescription recommendations were then distributed to the panelists for feedback and approval.

RESULTS

Twenty-three Mohs surgeons participated in the study. There was no scenario in which consensus was met to routinely provide an opioid prescription. However, there were several scenarios in which consensus were met to not routinely prescribe an opioid.

CONCLUSION

Opioids should not be routinely prescribed to every patient undergoing MMS. Prescription recommendations for opioids after MMS and reconstruction may decrease the exposure to these drugs and help combat the opioid epidemic.

Identifiants

DOI: 10.1097/DSS.0000000000002551 PMID: 32769528

pubmed: 32769528

pii: 00042728-202102000-00003

doi: 10.1097/DSS.0000000000002551

doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

167-169

Informations de copyright

Références

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