Reduction in Prescribed Opioids after General Surgery Procedures at a Public Hospital

Area of Science:

• Public Health
• Surgical Practice
• Health Services Research

Background:

• Opioid overdose is a leading cause of accidental death in the US.
• Surgeons frequently overprescribe opioids postoperatively.
• Public hospitals serve vulnerable populations with limited access to care.

Purpose of the Study:

• To assess the feasibility of implementing postoperative opioid prescribing guidelines in a public hospital setting.
• To evaluate the impact of standardized guidelines on opioid prescribing patterns and emergency department (ED) visits for pain.
• To improve pain management for general surgery patients in an underserved community.

Main Methods:

• A quality improvement project was implemented, including staff training and guideline distribution.
• Standardized opioid prescribing guidelines and patient education infographics were developed.
• Opioid prescriptions and ED visits were compared pre- and post-intervention for common general surgery procedures.

Main Results:

• The median number of prescribed opioid pills significantly decreased from 30 to 15 (P < 0.0001).
• Median morphine milligram equivalents prescribed decreased from 150 to 90 (P < 0.0001).
• The rate of postoperative pain-related ED visits remained low at 1.6%.

Conclusions:

• Standardized postoperative opioid prescribing guidelines can be successfully implemented in public hospitals.
• This intervention significantly reduced opioid prescribing without compromising patient pain management or increasing ED visits.
• The findings support the adoption of guideline-based opioid prescribing to combat the opioid crisis.