Education of trauma patients on opioids and pain management: A quality improvement project.
Journal
Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347
Informations de publication
Date de publication:
09 Oct 2024
09 Oct 2024
Historique:
received:
22
04
2024
revised:
08
08
2024
accepted:
09
09
2024
medline:
11
10
2024
pubmed:
11
10
2024
entrez:
10
10
2024
Statut:
aheadofprint
Résumé
Our acute care surgery team sustainably launched a pain management quality improvement project to reduce opioid prescriptions without affecting pain control in our elective surgery patients that was adopted on the inpatient acute care surgery service. Consequently, we implemented patient education on opioids and pain management aiming at decreasing opioid use without compromising pain management for acutely injured patients on the trauma service. Trauma patients admitted from August 1, 2021, to July 31, 2022, and discharged to home were included. Pain management education started on February 2022. Demographics, injury severity scores (ISSs), preadmission opioid and adjunct use, and type/dose of opioids and nonopioid adjuncts prescribed 24 hours predischarge and at discharge were collected. Opioids were converted to oral morphine milligram equivalents (MME). Phone calls for pain and opioid prescription refills were collected. The pre- and posteducation groups were compared using univariate analysis. Multivariate analyses were conducted to identify factors associated with phone calls for pain and opioid refills. Three hundred sixty-eight patients were included, 200 pre- and 168 posteducation. MME prescribed at discharge was positively associated with 24-hour predischarge MME (B = 0.010 [0.007-0.012], P < .001) and negatively associated with preinjury opioid use (B = -0.405 [-0.80 to -0.008], P = .045). Patient education led to an increased number of adjuncts prescribed (P < .008), decreased phone calls for pain (OR = 0.356 [0.165-0.770], P = .009), and decreased opioid refills (OR = 0.297 [0.131-0.675], P = .004), but no change in opioid prescriptions. Patient education on opioids and pain management led to decreased phone calls for inadequate pain management and decreased number of opioid refills.
Sections du résumé
BACKGROUND
BACKGROUND
Our acute care surgery team sustainably launched a pain management quality improvement project to reduce opioid prescriptions without affecting pain control in our elective surgery patients that was adopted on the inpatient acute care surgery service. Consequently, we implemented patient education on opioids and pain management aiming at decreasing opioid use without compromising pain management for acutely injured patients on the trauma service.
METHODS
METHODS
Trauma patients admitted from August 1, 2021, to July 31, 2022, and discharged to home were included. Pain management education started on February 2022. Demographics, injury severity scores (ISSs), preadmission opioid and adjunct use, and type/dose of opioids and nonopioid adjuncts prescribed 24 hours predischarge and at discharge were collected. Opioids were converted to oral morphine milligram equivalents (MME). Phone calls for pain and opioid prescription refills were collected. The pre- and posteducation groups were compared using univariate analysis. Multivariate analyses were conducted to identify factors associated with phone calls for pain and opioid refills.
RESULTS
RESULTS
Three hundred sixty-eight patients were included, 200 pre- and 168 posteducation. MME prescribed at discharge was positively associated with 24-hour predischarge MME (B = 0.010 [0.007-0.012], P < .001) and negatively associated with preinjury opioid use (B = -0.405 [-0.80 to -0.008], P = .045). Patient education led to an increased number of adjuncts prescribed (P < .008), decreased phone calls for pain (OR = 0.356 [0.165-0.770], P = .009), and decreased opioid refills (OR = 0.297 [0.131-0.675], P = .004), but no change in opioid prescriptions.
CONCLUSION
CONCLUSIONS
Patient education on opioids and pain management led to decreased phone calls for inadequate pain management and decreased number of opioid refills.
Identifiants
pubmed: 39389819
pii: S0039-6060(24)00714-1
doi: 10.1016/j.surg.2024.09.006
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest/Disclosure All authors declare no conflict of interest.