An Educational Intervention Reduces Opioids Prescribed Following General Surgery Procedures

Area of Science:

• Medical Education
• Surgical Practice
• Pain Management

Background:

• Opioid prescribing practices among surgeons exhibit significant variability.
• Excessive opioid prescription is a common issue, contributing to the opioid crisis.
• General surgery residents often prescribe more opioids than necessary postoperatively.

Purpose of the Study:

• To evaluate the effectiveness of a single educational intervention for general surgery residents.
• To determine if this intervention can reduce the quantity of postoperative opioids prescribed.
• To assess the impact on opioid type, nonopioid adjuncts, and refill requests.

Main Methods:

• Retrospective cohort study analyzing prescribing data 12 months before and 6 months after a 30-minute lecture.
• Lecture focused on opioid prescribing guidelines and multimodal analgesia for general surgery residents.
• Opioid volumes (oral morphine equivalents, OME), type, nonopioid use, and refills were analyzed for opioid-naïve patients undergoing specific surgical procedures.

Main Results:

• Median OME prescribed decreased significantly across multiple procedures including excisional breast biopsy, laparoscopic appendectomy, and hernia repairs.
• Post-intervention, fewer patients received opioids alone, with more receiving opioids combined with two nonopioid adjuncts (P < 0.001).
• Opioid refill requests decreased from 11.9% to 7.2% (P = 0.014), and oxycodone use increased while acetaminophen-containing combinations decreased.

Conclusions:

• A targeted educational intervention effectively reduced postoperative opioid prescribing (OME) among general surgery residents.
• The intervention led to increased use of nonopioid analgesics and a decrease in patient refill requests.
• Integrating opioid prescribing guidelines and multimodal therapy education into the annual didactic curriculum is recommended.