ArticleJoint Commission journal on quality and patient safety2020
Standardizing Opioid Prescriptions to Patients After Ambulatory Oncologic Surgery Reduces Overprescription.
Article in Joint Commission journal on quality and patient safety, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quality improvement interventions in surgical oncology: systematic review of international studies.BJS open · 2026Pooled it
- The prevalence and predictors of discharge opioid overprescribing in opioid-naïve patients after breast, gynecologic, and head and neck cancer surgery: a prospective cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Article
- Reducing opioid prescribing after ambulatory breast reconstruction surgery.Journal of surgical oncology · 2023Article
- Implementation and Assessment of No Opioid Prescription Strategy at Discharge After Major Urologic Cancer Surgery.JAMA surgery · 2023Article
- An Enhanced Recovery After Surgery protocol for robotic-assisted laparoscopic nephrectomies utilizing a quadratus lumborum block.Journal of robotic surgery · 2022Article
- Article
- A prospective feasibility study evaluating the 5x-multiplier to standardize discharge prescriptions in cancer surgery patients.Surgery open science · 2022Article
- Characterization of Symptoms after Radical Prostatectomy and Their Relation to Postoperative Complications.The Journal of urology · 2022Article
- Opioid Use Consequences, Governmental Strategies, and Alternative Pain Control Techniques Following Total Hip Arthroplasties.Orthopedic reviews · 2022Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundOverprescribing of opioids after surgery contributes to long-term abuse. Evaluating opioid prescription patterns and patient-reported opioid use offers an evidence-based method to identify potential overprescription. This quality improvement initiative aimed to reduce and standardize opioid prescriptions upon discharge from an ambulatory oncologic surgery center and evaluate the effect of this change on patients' subsequent opioid use and reported pain.
methodsBetween March 2018 and January 2019, consecutive opioid-naïve patients aged ≥ 18 years who underwent robotic or laparoscopic hysterectomy, radical prostatectomy, or partial nephrectomy, or total mastectomy with or without immediate reconstruction were surveyed 7-10 days postoperatively. Data collected in the pre- (n = 551) and post-standardization (n = 480) cohorts included perception of pain relief, opioids prescribed (verified by electronic medical record review) and consumed, and refills received.
resultsPre-standardization, the median opioid prescription at discharge was 20 pills (interquartile range [IQR] 20-28) or 140 oral morphine milligram equivalents (MME) (IQR 100-150). Median opioid consumption was 2 pills (IQR 0-7) or 10 MME (IQR 0-40) among all services. Opioid prescriptions were later standardized to 7, 8, and 10 pills (35, 40, and 75 MME), in the gynecology, urology, and breast services, respectively. The change was not associated with an increase in reported pain. Refill requests increased postintervention across all surgeries from 4.4% to 7.7%, with the largest increase among patients who underwent breast surgery.
conclusionThe number of opioid pills given at discharge to patients undergoing ambulatory or short-stay cancer surgery can safely be reduced.
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