ArticleObstetrics and gynecology2019
Effects of Shared Decision Making on Opioid Prescribing After Hysterectomy.
Article in Obstetrics and gynecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Preemptive local analgesia at vaginal hysterectomy: a systematic review.International urogynecology journal · 2022Pooled it
- Article
- Adults' experiences of perioperative opioid use: a mixed-methods study.Pain reports · 2026Article
- Review
- Optimization of Postoperative Opioids Use Following Spine Surgery.Current pain and headache reports · 2025Review
- Mobile health supported multi-domain recovery trajectories after major arthroplasty or spine surgery: a pilot feasibility and usability study.BMC musculoskeletal disorders · 2023Observational
- Improving pain management and safe opioid use after surgery: A DMAIC-based quality intervention.Surgery open science · 2023Article
- Shared decision-making for postoperative opioid prescribing and preoperative pain management education decreases excess opioid burden.Surgical endoscopy · 2023Article
- Article
- Raising patient and carer awareness of the risks of postoperative opioids.British journal of pain · 2022Article
- Evaluation of Factors Relevant to Pain Control Among Patients After Surgical Treatment.JAMA network open · 2021Article
- Patient decision aid for trial of labor after cesarean (TOLAC) versus planned repeat cesarean delivery: a quasi-experimental pre-post study.BMC pregnancy and childbirth · 2021Article
- Reducing New Persistent Opioid Use After Surgery: A Review of Interventions.Current pain and headache reports · 2021Review
- Mixed Methods Study of Patient and Primary Care Provider Perceptions of Chronic Pain Treatment.Patient education and counseling · 2021Article
- Evaluation of a new departmental policy to decrease routine opioid prescribing after vaginal delivery.American journal of obstetrics & gynecology MFM · 2020Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 2 countries.
Funding
Abstract
objectiveTo evaluate the effects of shared decision making using a simple decision aid for opioid prescribing after hysterectomy.
methodsWe conducted a prospective quality initiative study including all patients undergoing hysterectomy for benign, nonobstetric indications between March 1, 2018, and July 31, 2018, at our academic institution. Using a visual decision aid, patients received uniform education regarding postoperative pain management. They were then educated on the department's guidelines regarding the maximum number of tablets recommended per prescription and the mean number of opioid tablets used by a similar cohort of patients in a previously published study at our institution. Patients were then asked to choose their desired number of tablets to receive on discharge. Structured telephone interviews were conducted 14 days after surgery. The primary outcome was total opioids prescribed before compared with after implementation of the decision aid. Secondary outcomes included opioid consumption, patient satisfaction, and refill requests after intervention implementation.
resultsOf 170 eligible patients, 159 (93.5%) used the decision aid (one patient who used the decision aid was subsequently excluded from the analysis owing to significant perioperative complications), including 110 (69.6%) laparoscopic, 40 (25.3%) vaginal, and eight (5.3%) abdominal hysterectomies. Telephone surveys were completed for 89.2% (n=141) of participants. Student's t-test showed that patients who participated in the decision aid (post-decision aid cohort) were discharged with significantly fewer oral morphine equivalents than patients who underwent hysterectomy before implementation of the decision aid (pre-decision aid cohort) (92±35 vs 160±81, P<.01), with no significant change in the number of requested refills (9.5% [n=15] vs 5.7% [n=14], P=.15). In the post-decision aid cohort, 76.6% of patients (n=121) chose fewer tablets than the guideline-allotted maximum. Approximately 76% of patients (n=102) reported having leftover tablets.
conclusionThis quality improvement initiative illustrates that a simple decision aid can result in a significant decrease in opioid prescribing without compromising patient satisfaction or postoperative pain management.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.