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Implementation of a Quality Improvement Initiative to Decrease Opioid Prescribing in General Surgery.

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Summary
This summary is machine-generated.

Opioid overprescribing after surgery decreased significantly when surgeons received patient consumption data. Patients used only 42% of prescribed opioids, highlighting a need for better prescribing practices.

Keywords:
General surgeryNarcoticOpioidQuality improvement

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Area of Science:

  • Pain Management
  • Surgical Outcomes
  • Health Services Research

Background:

  • Growing need to reduce excess opioid prescribing post-surgery.
  • Overprescription was prospectively assessed in a large hospital system.
  • Data informed a quality improvement intervention to curb overprescribing.

Purpose of the Study:

  • To assess opioid overprescription following surgical procedures.
  • To implement and evaluate a quality improvement initiative targeting opioid prescribing.
  • To analyze the impact of patient consumption data on surgeon prescribing habits.

Main Methods:

  • Prospective assessment of opioid prescribing and consumption via email surveys in a 23-hospital system (January 2017-2018).
  • Implementation of surgeon guidelines based on patient consumption data in January 2018.
  • Statistical analysis using Wilcoxon signed-rank, ANOVA, and Cuzick trend tests.

Main Results:

  • Opioid prescribing decreased from median 30 (IQR: 24-45) to 18 (IQR: 12-30) (P < 0.001).
  • Opioid consumption decreased from median 12 (IQR: 7-20) to 8 (IQR: 3-15) (P < 0.001).
  • Patients consumed a median of 42% of prescribed opioids, with no significant trend over time.

Conclusions:

  • Significant reduction in prescribed and consumed opioids post-intervention.
  • Surgeon feedback on patient consumption data effectively reduced opioid prescribing.
  • Identified a substantial gap between prescribed and consumed opioids in surgical patients.