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How to close the gaps between evidence and practice for perioperative opioids
Jennifer A Stevens1,2,3, Bernadette R Findlay3
1St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
Anaesthesia and Intensive Care
|February 16, 2022
Summary
Evidence-based guidelines for perioperative opioid prescribing exist, but adoption varies. This article addresses the gap between opioid prescribing recommendations and actual practice, suggesting strategies to improve adherence.
Area of Science:
- Pain Management
- Surgical Care
- Evidence-Based Medicine
Background:
- Numerous evidence-based resources exist for perioperative opioid prescribing to prevent harm.
- While some recommendations are widely adopted, others show slow and inconsistent implementation in clinical practice.
Purpose of the Study:
- To identify specific areas where opioid prescribing recommendations diverge from current practice.
- To propose strategies for bridging the gap between evidence-based guidelines and clinical application.
Main Methods:
- Analysis of existing literature and consensus statements on perioperative opioid prescribing.
- Identification of discrepancies between recommended practices and observed clinical behaviors.
- Exploration of implementation science principles to guide strategy development.
Main Results:
- Significant variability exists in the adoption of opioid prescribing guidelines.
- Education alone is insufficient to drive behavior change in opioid prescribing.
- Structural interventions and localized analgesic pathways are crucial for improving adherence.
Conclusions:
- Closing the gap in perioperative opioid prescribing requires more than just education.
- Implementing structural nudges and procedure-specific analgesic pathways can enhance the adoption of evidence-based practices.
- Sustained efforts are needed to align clinical practice with expert recommendations for preventing opioid-related harm.
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