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Postsurgical opioid prescribing interventions, including organizational changes and clinician guidelines, can reduce opioid use. More high-quality studies are needed to determine the most effective strategies for reducing opioid prescribing after surgery.

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Area of Science:

  • Pain Management
  • Public Health
  • Surgical Care

Background:

  • Opioid misuse and addiction are at epidemic levels in the U.S.
  • Postsurgical prescribing is a key intervention point for the opioid epidemic.
  • Interventions must balance pain control with reduced opioid reliance.

Purpose of the Study:

  • To examine interventions for changing postsurgical opioid prescribing practices.
  • To identify effective strategies for opioid stewardship in surgical discharge.

Main Methods:

  • Systematic review of studies published after 2000 on postsurgical opioid stewardship.
  • Searches of PubMed and Embase databases, supplemented by citation tracking.
  • Quality assessment of included studies using a standardized tool.

Main Results:

  • Eight studies met inclusion criteria, utilizing various study designs.
  • Organizational-level interventions (EHR changes, workflow modifications) showed positive results.
  • Guidelines based on patient opioid use reduced prescribed quantities by up to 53% without increasing ED visits or refills.

Conclusions:

  • Clinician-mediated and organizational interventions effectively change postsurgical opioid prescribing.
  • A paucity of high-quality studies exists regarding the most effective interventions.
  • Further research is needed to optimize postsurgical opioid stewardship.