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Description and Impact of a Comprehensive Multispecialty Multidisciplinary Intervention to Decrease Opioid

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    A hospital initiative significantly reduced opioid prescribing after surgery by implementing guidelines and education. This approach also eliminated racial and gender disparities in opioid prescriptions without increasing refills.

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    Area of Science:

    • Surgery
    • Public Health
    • Pain Management

    Background:

    • Diversion of prescription opioids is a major contributor to the ongoing opioid epidemic.
    • Reducing opioid prescribing in surgical settings is crucial for public health.

    Purpose of the Study:

    • To evaluate the impact of a comprehensive, multi-specialty initiative aimed at decreasing opioid prescribing in surgery.
    • To assess changes in opioid prescribing patterns, including refills and disparities.

    Main Methods:

    • A multispecialty, multidisciplinary initiative was implemented, including opioid guidelines, patient education materials, and provider training.
    • Pre- and post-initiative analyses compared opioid prescribing at discharge (median oral morphine equivalent - OME) for 23,298 patients across 11 specialties.
    • Opioid refills within three months were also analyzed.

    Main Results:

    • The initiative led to a significant decrease in median OME for 10 specialties post-implementation.
    • The percentage of patients discharged without opioids increased from 35.7% to 52.5%.
    • No significant change in opioid refill rates was observed, and pre-initiative race/sex disparities in prescribing disappeared.

    Conclusions:

    • A comprehensive, multi-specialty intervention effectively reduced opioid prescribing in surgical patients.
    • The initiative successfully decreased disparities in opioid prescribing based on race and sex.
    • The intervention demonstrated a sustainable model for reducing opioid use without compromising patient care or increasing refill rates.