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Postoperative Opioid Prescription Reduction Strategy in a Regional Healthcare System
Richard Frazee1, Emily Garmon2, Claire Isbell1
1Department of Surgery, Baylor Scott & White Healthcare, Temple, TX.
Journal of the American College of Surgeons
|March 30, 2020
Summary
A system-wide opioid stewardship program significantly reduced long-term opioid discharge prescriptions for surgical patients. This initiative offers a model for healthcare systems combating the opioid crisis.
Area of Science:
- Pain Management
- Opioid Stewardship
- Public Health
Background:
- The Centers for Disease Control and Prevention (CDC) noted increased opioid use probability after 5 and 31 days of therapy.
- Opioid prescribing practices require careful management to prevent long-term use and address the opioid crisis.
Purpose of the Study:
- To evaluate the impact of a system-wide pain management and opioid stewardship initiative on reducing opioid discharge prescriptions for elective surgical patients.
Main Methods:
- A multipronged approach including educational conferences and Enhanced Recovery after Surgery protocols was implemented.
- A quality metric incentivized surgeons to limit postoperative opioid discharge prescriptions to 5 days or fewer.
- Prescribing data from 31,814 patients were analyzed quarterly from January 2018 to March 2019.
Main Results:
- The rate of opioid prescriptions for 5 days or fewer increased from 81% at baseline to 92% by the final quarter.
- A statistically significant increase in shorter opioid prescriptions was observed following the interventions (p < 0.0001).
Conclusions:
- A comprehensive pain management and opioid stewardship program effectively reduced the duration of opioid discharge prescriptions.
- This model can guide other healthcare systems in mitigating opioid prescribing and addressing the national opioid crisis.
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