ArticleBMJ quality & safety2021
Assessment of a quality improvement intervention to decrease opioid prescribing in a regional health system.
Article in BMJ quality & safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04805229 (Using Difference-in-Differences to Evaluate the Effect of a Statewide Quality Improvement Program on New Persistent Opioid Use After Surgery), which is not on this map. Cited by 15 papers.
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Using Difference-in-Differences to Evaluate the Effect of a Statewide Quality Improvement Program on New Persistent Opioid Use After Surgery
Who cites it
15 citing papers in PubMed.
- What predicts postoperative opioid prescribing and consumption? A statewide analysis of surgical quality registry data.Pain medicine (Malden, Mass.) · 2026Article
- Article
- Preoperative Patient Education as a Tool for Reducing Postoperative Opioid Use Following Primary Total Hip Arthroplasty: One Institution's Experience.Arthroplasty today · 2025Article
- Toward Opioid-Free Total Hip Arthroplasty: A Retrospective Study of a Targeted Opioid Reduction Program in 229 Patients.Arthroplasty today · 2025Article
- Impact of COVID-19 on Opioid Prescribing, Consumption, Pain, and Outcomes after Surgery.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Article
- Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative Registry.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Learning from the implementation of a surgical opioid reduction initiative in an integrated health system: a qualitative study among providers and patients.Implementation science communications · 2024Article
- Perioperative Opioid-Related Harms: Opportunities to Minimize Risk.Seminars in plastic surgery · 2024Review
- What evidence is needed to inform postoperative opioid consumption guidelines? A cohort study of the Michigan Surgical Quality Collaborative.Regional anesthesia and pain medicine · 2024Article
- Effect of Best Practice Alert (BPA) on Post-Discharge Opioid Prescribing After Minimally Invasive Hysterectomy: A Quality Improvement Study.Journal of pain research · 2024Article
- Prescribed Opioid Dosages, Payer Type, and Self-Reported Outcomes After Surgical Procedures in Michigan, 2018-2020.JAMA network open · 2023Article
- Association of opioid exposure before surgery with opioid consumption after surgery.Regional anesthesia and pain medicine · 2022Article
- Perioperative Opioids, the Opioid Crisis, and the Anesthesiologist.Anesthesiology · 2022Article
- Addressing the ignored complication: chronic opioid use after surgery.BMJ quality & safety · 2021Article
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7 authors.
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Abstract
backgroundOpioids are prescribed in excess after surgery. We leveraged our continuous quality improvement infrastructure to implement opioid prescribing guidelines and subsequently evaluate changes in postoperative opioid prescribing, consumption and patient satisfaction/pain in a statewide regional health system.
methodsWe collected data regarding postoperative prescription size, opioid consumption and patient-reported outcomes from February 2017 to May 2019, from a 70-hospital surgical collaborative. Three iterations of prescribing guidelines were released. An interrupted time series analysis before and after each guideline release was performed. Linear regression was used to identify trends in consumption and patient-reported outcomes over time.
resultsWe included 36 022 patients from 69 hospitals who underwent one of nine procedures in the guidelines, of which 15 174 (37.3%) had complete patient-reported outcomes data following surgery. Before the intervention, prescription size was decreasing over time (slope: -0.7 tablets of 5 mg oxycodone/month, 95% CI -1.0 to -0.5 tablets, p<0.001). After the first guideline release, prescription size declined by -1.4 tablets/month (95% CI -1.8 to -1.0 tablets, p<0.001). The difference between these slopes was significant (p=0.006). The second guideline release resulted in a relative increase in slope (-0.3 tablets/month, 95% CI -0.1 to -0.6, p<0.001). The third guideline release resulted in no change (p=0.563 for the intervention). Overall, mean (SD) prescription size decreased from 25 (17) tablets of 5 mg oxycodone to 12 (8) tablets. Opioid consumption also decreased from 11 (16) to 5 (7) tablets (p<0.001), while satisfaction and postoperative pain remained unchanged.
conclusionsThe use of procedure-specific prescribing guidelines reduced statewide postoperative opioid prescribing by 50% while providing satisfactory pain care. These results demonstrate meaningful impact on opioid prescribing using evidence-based best practices and serve as an example of successful utilisation of a regional health collaborative for quality improvement.
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