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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
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Optimization of Opioid Discharge Prescriptions Following Thyroid and Parathyroid Surgery
Elsie Rizk1,2, Fangzheng Yuan1,2, Feibi Zheng2
1Department of Pharmacy, Houston Methodist, Houston, Texas, USA.
Summary
A quality improvement bundle significantly reduced opioid discharge prescriptions after thyroidectomy and parathyroidectomy. This initiative helps decrease unused opioids and lowers the risk of misuse in the community.
Area of Science:
- Endocrinology
- Surgical Oncology
- Pain Management
Background:
- Opioid discharge prescriptions after thyroidectomy and parathyroidectomy are a concern due to potential misuse.
- Unused opioids in homes can lead to diversion and community opioid misuse.
Purpose of the Study:
- To evaluate the impact of a quality improvement (QI) bundle on opioid discharge prescribing patterns.
- To assess the effectiveness of a QI bundle in reducing new opioid prescriptions post-thyroidectomy and parathyroidectomy.
Main Methods:
- A before-and-after study design was employed at an academic medical center.
- The QI bundle included patient education, EHR order sets with multimodal analgesia, and provider education.
- Opioid discharge prescribing rates were compared between preimplementation (Jan 2018-Dec 2019) and postimplementation (Jun 2021-Aug 2021) cohorts.
Main Results:
- New opioid discharge prescriptions decreased from 80% preimplementation to 35% postimplementation (45% absolute reduction).
- The QI bundle was associated with a significant reduction in the odds of receiving opioid discharge prescriptions (OR, 0.08; P < .001).
- Reductions were also observed in total opioid dosage (112.5 MME) and duration of therapy (5 days).
Conclusions:
- Implementation of a pain management QI bundle effectively reduced opioid discharge prescribing after thyroidectomy and parathyroidectomy.
- This intervention has the potential to decrease the risk of opioid misuse by limiting the availability of unused opioids.
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