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Decreasing Postoperative Opioid Prescribing through Education.

Lynn Nguyen1, Stacey Bowlds1, Christina Munford1

  • 1HCA Memorial Savannah, Savannah, Georgia.

Journal of Surgical Education
|December 21, 2019
PubMed
Summary
This summary is machine-generated.

A single educational intervention significantly reduced postoperative opioid prescribing (morphine milligram equivalents) by 21.8% in general surgery patients. This reduction did not lead to increased opioid refills, emergency visits, or readmissions.

Keywords:
opioid epidemicopioid prescribingpain controlpostoperative painsurgical educationsurgical residency

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Area of Science:

  • Surgical Education
  • Pain Management
  • Opioid Prescribing Practices

Background:

  • Postoperative pain management often involves opioid prescriptions.
  • Concerns exist regarding the impact of opioid prescribing on patient refills and healthcare utilization.
  • Educational interventions are a potential strategy to modify resident prescribing habits.

Purpose of the Study:

  • To evaluate the effect of an educational intervention on surgical residents' postoperative opioid prescribing.
  • To determine if reduced opioid prescription amounts correlate with changes in patient refill rates, emergency department visits, or readmissions.

Main Methods:

  • Prospective sequential cohort study conducted at a tertiary care center.
  • Included opioid-naive patients undergoing common general surgeries (appendectomy, cholecystectomy, colectomy, hernia repair, lumpectomy, mastectomy).
  • Data collected from November 2017 to February 2018.

Main Results:

  • Average morphine milligram equivalents (MME) prescribed per patient decreased by 21.8% post-intervention.
  • Largest MME reductions observed in breast (38%) and gallbladder (25%) surgeries.
  • No significant increase in opioid refills, emergency department visits, or readmissions was noted.

Conclusions:

  • A single educational intervention effectively reduced postoperative opioid MME in general surgery.
  • Decreased opioid prescribing did not adversely affect patient outcomes related to refills or healthcare utilization.
  • This highlights the potential of targeted education to optimize opioid stewardship in surgical residency programs.