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A Pathway for Developing Postoperative Opioid Prescribing Best Practices.

Ryan Howard1,2, Joceline Vu1,2, Jay Lee1,2

  • 1Department of Surgery, University of Michigan, Ann Arbor, MI.

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|September 4, 2019
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Summary
This summary is machine-generated.

Implementing evidence-based guidelines for postoperative opioid prescribing significantly reduced opioid use by 37-63% without impacting patient pain scores. This approach utilizes a learning health system model for quality improvement in pain management.

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Area of Science:

  • Medical Science
  • Public Health
  • Health Policy

Background:

  • Opioid prescriptions are effective for surgical pain but contribute to the opioid epidemic.
  • Overprescribing post-surgery leads to adverse outcomes like diversion and opioid use disorder.

Purpose of the Study:

  • To review pragmatic approaches for developing and implementing evidence-based guidelines for postoperative opioid prescribing.
  • To apply a learning health system model for guideline development and implementation.

Main Methods:

  • Conducted a MEDLINE/PubMed review of published examples.
  • Reviewed institutional experience in developing and implementing evidence-based postoperative prescribing recommendations.
  • Utilized learning health system principles for quality improvement cycles.

Main Results:

  • Thirty studies analyzed 13,591 patients regarding opioid prescribing and use.
  • Three studies showed successful implementation of opioid prescribing recommendations.
  • Reduced opioid prescribing by 37% to 63% without increasing refill requests or pain scores.

Conclusions:

  • Evidence-based opioid prescribing guidelines can be implemented in various settings.
  • This approach significantly decreases opioid prescribing.
  • Patient outcomes are not adversely affected by reduced opioid prescribing.