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Opioid Stewardship Program and Postoperative Adverse Events: A Difference-in-differences Cohort Study.

Antje M Barreveld1, Robert J McCarthy, Nabil Elkassabany

  • 1From the Department of Anesthesiology, Newton-Wellesley Hospital, Newton, Massachusetts (A.M.B.) the Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois (R.J.M., A.B.) the Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania (N.E.) the Anesthesiology and Perioperative Care Service, Department of Veterans Affairs Palo Alto Health Care System, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California (E.R.M.) the Department of Anesthesiology and Perioperative Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (B.S.) Premier, Inc., Premier Government Services, Charlotte, North Carolina (R.G.).

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Summary
This summary is machine-generated.

A hospital opioid educational program did not reduce opioid-related harm or change opioid use. Limited-duration interventions may not significantly alter hospital opioid analgesic practices.

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Area of Science:

  • Clinical Pharmacy
  • Patient Safety
  • Pain Management

Background:

  • Opioid use in hospitals presents risks, including adverse events and addiction.
  • Educational programs aim to improve pain management and reduce opioid-related harm.
  • A 6-month intervention combining webinars and coaching was implemented across 31 hospitals.

Purpose of the Study:

  • To evaluate the effectiveness of a hospital-wide opioid educational program.
  • To determine if the intervention reduced opioid-related harm and altered opioid use.
  • To compare outcomes between intervention and non-intervention hospitals.

Main Methods:

  • A prospective study comparing 31 intervention hospitals with 33 non-intervention hospitals.
  • Outcomes including opioid overdose, wrong substance administration, and respiratory failure were tracked for 12 months pre- and post-intervention.
  • Differences-in-differences analysis was used to compare changes in outcomes between groups.

Main Results:

  • The intervention did not significantly reduce the incidence of opioid overdose or wrong substance administration.
  • A significant decrease in respiratory failure was observed in intervention hospitals, but naloxone administration increased.
  • Average daily opioid use and the proportion of patients receiving high opioid doses remained unchanged.

Conclusions:

  • A 6-month opioid educational intervention did not effectively reduce opioid adverse events or alter overall opioid use.
  • Findings suggest that short-term educational initiatives may be insufficient to substantially change hospital opioid prescribing.
  • Further research into sustained interventions is needed to improve opioid stewardship in healthcare settings.