Evidence map›Paper›PMID 33305251›Full record

ArticleAmerican journal of obstetrics & gynecology MFM2020

Evaluation of a new departmental policy to decrease routine opioid prescribing after vaginal delivery.

Nina Olsen, Alexandra Eagan, Kristin Romutis, Mishka Terplan, Caitlin E Martin

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of obstetrics & gynecology MFM, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Nurses' Perspectives on Postpartum Pain Management.Women's health reports (New Rochelle, N.Y.) · 2022
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nina OlsenDepartment of Obstetrics and Gynecology, Virginia Physicians for Women, North Chesterfield, VA (Dr Olsen); Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA (Dr Eagan); Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA (Dr Romutis); Senior Physician Research Scientist, Friends Research Institute, Baltimore, MD (Dr Terplan); and Department of Obstetrics and Gynecology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA (Dr Martin).
Alexandra EaganDepartment of Obstetrics and Gynecology, Virginia Physicians for Women, North Chesterfield, VA (Dr Olsen); Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA (Dr Eagan); Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA (Dr Romutis); Senior Physician Research Scientist, Friends Research Institute, Baltimore, MD (Dr Terplan); and Department of Obstetrics and Gynecology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA (Dr Martin).
Kristin RomutisDepartment of Obstetrics and Gynecology, Virginia Physicians for Women, North Chesterfield, VA (Dr Olsen); Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA (Dr Eagan); Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA (Dr Romutis); Senior Physician Research Scientist, Friends Research Institute, Baltimore, MD (Dr Terplan); and Department of Obstetrics and Gynecology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA (Dr Martin).
Mishka TerplanDepartment of Obstetrics and Gynecology, Virginia Physicians for Women, North Chesterfield, VA (Dr Olsen); Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA (Dr Eagan); Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA (Dr Romutis); Senior Physician Research Scientist, Friends Research Institute, Baltimore, MD (Dr Terplan); and Department of Obstetrics and Gynecology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA (Dr Martin).
Caitlin E MartinDepartment of Obstetrics and Gynecology, Virginia Physicians for Women, North Chesterfield, VA (Dr Olsen); Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA (Dr Eagan); Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA (Dr Romutis); Senior Physician Research Scientist, Friends Research Institute, Baltimore, MD (Dr Terplan); and Department of Obstetrics and Gynecology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA (Dr Martin).

Funding

Research Supplement to Promote Diversity in Health Related ResearchUL1TR002649 · NCATS · VIRGINIA COMMONWEALTH UNIVERSITY · PI MOELLER, FREDERICK GERARD · 2018 to 2022
$19.1M
Institutional Career Development CoreKL2TR002648 · NCATS · VIRGINIA COMMONWEALTH UNIVERSITY · PI NANASINKAM, SERGE PATRICK, SANYAL, ARUN J · 2018 to 2022
$3.7M
CTSA K12 Program at Virginia Commonwealth UniversityK12TR004364 · NCATS · VIRGINIA COMMONWEALTH UNIVERSITY · PI SERGE PATRICK NANASINKAM, Gretchen N Neigh · 2023 to 2026
$3.0M
NCATS NIH HHS K12 TR004364NCATS NIH HHS KL2 TR002648NCATS NIH HHS UL1 TR002649
6 · The paper itself

Abstract

backgroundIn line with a nationwide commitment to decrease opioid prescribing, in October 2017, our department implemented a new departmental policy to cease routine provision of opioid prescriptions at the time of discharge following vaginal delivery.

objectiveThis study aimed to evaluate the effect of this policy on the number of discharge opioid prescriptions provided and outpatient encounters observed postpartum. STUDY

designThis was a retrospective cohort study of patients who underwent vaginal delivery at our institution from November 2016 to January 2018. We reviewed delivery and postpartum records for patients 18 years or older, without chronic opioid use or contraindication to nonsteroidal antiinflammatory medication use. The primary outcome was the proportion of patients provided with an opioid prescription at the time of discharge following vaginal delivery. The secondary outcome was the number of unscheduled patient encounters related to pain in the 6-week postpartum period. Fisher's exact test was used to compare these outcomes before and after implementation of the new departmental opioid-prescribing policy.

resultsA total of 1188 charts were reviewed; among those charts, 810 met the inclusion criteria. Notably, 405 patients delivered before the guideline, and 405 patients delivered after its implementation. After the implementation of the new departmental policy, there was a 10-fold decrease in opioid prescriptions provided from 323 (79.8%) to 29 (7.2%) (

conclusionLimiting opioid prescribing after vaginal delivery is associated with a considerable decrease in the number of discharge opioid prescriptions provided and does not significantly increase the number of outpatient encounters related to pain postpartum.

Indexed as

Analgesics, OpioidDrug PrescriptionsDelivery, ObstetricFemaleHumansPolicyPostoperative PainPractice Patterns, Physicians'PregnancyRetrospective StudiesAnalgesics, Opioidopioidspain-related encounterspostpartum

Identifiers

PMID33305251
PMCPMC7725266

What OpenQuestion holds

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Registered trials

None linked

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.