ArticleGynecologic oncology reports2022
Optimizing post-operative opiate prescribing following gynecologic surgery.
Article in Gynecologic oncology reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors at 2 institutions in 1 country.
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Abstract
Background: Post-operative opiate prescribing has traditionally been stratified by procedure type with little regard for patient opiate utilization. We sought to evaluate peri-operative factors associated with patient opiate utilization post-operatively to develop, implement, and assess a discharge prescribing intervention. Study design: This was a quality improvement study of opiate prescribing practices for patients undergoing gynecologic surgery on an enhanced recovery pathway (ERAS) pre- and post-discharge prescription intervention. In the pre-intervention cohort (12/2018 to 05/2019), peri-operative factors (demographic, procedure, and pain scores) associated with post-operative patient opiate usage and quantity of opiate prescribed were identified. A discharge planning intervention based solely on opiate usage was implemented. The pre- and post-intervention cohort (07/2020 to 09/2020) were compared to assess changes in post-operative opiate prescribing and refill requests. Results: There were 220 patients in the pre-intervention cohort and 120 patients post-intervention. Post-operative opiate usage in the pre-intervention cohort was correlated only with pain score and age (p < 0.001, p = 0.04). Quantity of opiate prescribed was correlated only with procedure type and not reflective of patient opiate usage. Using this information, a discharge planning intervention for opiate prescription informed by opiate usage in the twenty-four hours prior to discharge was added to the discharge order set. Post-intervention, adherence to recommended prescription was 40.8%. Opiate prescriptions decreased from a mean 27.3 tablets to 14.8 tablets (p < 0.001). Conclusions: A tailored, patient specific approach to post-operative opiate prescribing can significantly decrease the quantity of opiates prescribed.
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