Opioid Misuse and Dependence Screening Practices Prior to Surgery.

Area of Science:

• Surgical patient care
• Pain management
• Opioid use disorder screening

Background:

• Opioid prescriptions are common for surgical patients.
• Pre-existing opioid use and opioid use disorders (OUD) complicate perioperative management.
• Preoperative opioid users face higher risks of developing OUD post-surgery.

Purpose of the Study:

• To examine the prevalence of preoperative opioid screening.
• To assess the documentation of opioid screening in electronic medical records (EMR).
• To identify barriers to preoperative opioid screening among surgical providers.

Main Methods:

• A survey of 268 patients and a chart review of 100 patients were conducted.
• Log-binomial models analyzed the association between provider role and screening documentation.
• Qualitative interviews explored barriers to screening and documentation.

Main Results:

• Only 7% of patients underwent preoperative opioid screening.
• 38% of patients self-reported past-year opioid use, but only 3% had documented screening.
• Provider role did not significantly influence screening documentation; EMRs were often discordant with patient reports.

Conclusions:

• Preoperative opioid screening is infrequent, and EMR documentation is often inaccurate.
• Addressing barriers like time constraints and workflow integration is crucial.
• Enhanced health system support is needed to improve screening practices and documentation.