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Individualized Compared With Standard Postdischarge Oxycodone Prescribing After Cesarean Birth: A Randomized
Sarah S Osmundson1, Britany L Raymond, Bradley T Kook
1Departments of Obstetrics and Gynecology and Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; the University of Utah, Salt Lake City, Utah; and Vanderbilt University, Nashville, Tennessee.
Obstetrics and Gynecology
|August 11, 2018
Summary
Individualized oxycodone prescriptions based on inpatient use significantly reduced unused opioid tablets after cesarean birth. This approach led to 50% fewer leftover pills compared to standard prescribing, optimizing pain management and reducing waste.
Area of Science:
- Obstetrics and Gynecology
- Pain Management
- Pharmacology
Background:
- Cesarean birth often involves opioid pain management, leading to a significant number of unused opioid tablets.
- Standard postdischarge opioid prescribing may not align with individual patient needs, contributing to medication waste and potential misuse.
- Optimizing opioid prescribing after cesarean delivery is crucial for effective pain control and responsible medication management.
Purpose of the Study:
- To determine if individualized postdischarge oxycodone prescribing, guided by inpatient opioid consumption, decreases the quantity of unused opioid tablets following cesarean birth.
- To compare the number of unused oxycodone tablets between women receiving standard prescriptions versus those receiving individualized prescriptions.
- To assess the impact of individualized prescribing on overall opioid utilization and patient-reported pain outcomes.
Main Methods:
- A randomized controlled trial involving women aged 18 years or older undergoing cesarean birth.
- Participants were assigned to either a standard prescription (30 oxycodone tablets) or an individualized prescription based on inpatient opioid use.
- Outcomes, including unused tablets and pain control, were assessed via patient contact and prescription monitoring databases.
Main Results:
- The individualized prescription group received fewer tablets (14 vs. 30) and had 50% fewer unused tablets compared to the standard group (5 vs. 10).
- Women in the individualized group used half the number of prescribed opioids (8 vs. 15).
- No significant differences were observed in the proportion of women using no or all opioids, or in patient-reported pain outcomes between the groups.
Conclusions:
- Individualized opioid prescribing, tailored to inpatient use, effectively reduces the number of unused oxycodone tablets after cesarean birth.
- This strategy offers a more precise approach to pain management, minimizing medication waste.
- Individualized prescribing demonstrates potential for optimizing opioid use in the postpartum period without compromising pain relief.
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