Evaluating Adherence of Evidence-Based Post-Operative Discharge Opioid Prescribing Guidelines and Patient Outcomes...

Area of Science:

• Pharmacology
• Public Health
• Health Services Research

Background:

• Inappropriate prescribing of discharge analgesia is a public health concern.
• A tertiary Australian hospital developed Postoperative Inpatients Discharge Analgesia Guidelines in 2015.
• Previous audits in 2016 and 2017 showed declining compliance.

Purpose of the Study:

• To assess ongoing compliance with discharge analgesia guidelines five years post-implementation.
• To evaluate patient outcomes, clinical impact, and minimization of harmful events related to discharge analgesia.

Main Methods:

• Prescribing data for discharge analgesics were collected from 200 surgical patients (August 2019 - April 2020).
• Records were audited against the hospital's guidelines and compared to previous audits.
• Patients were interviewed by telephone two weeks post-discharge.

Main Results:

• Compliance increased for paracetamol (100%), celecoxib (98%), tramadol IR (89%), and pregabalin (89%).
• 56% of surveyed patients reported a mean pain score of 2/10 two weeks post-discharge.
• High rates of unused medication (43%), improper storage (88% in unlocked locations), and poor return rates (6%) were observed.

Conclusions:

• Compliance with discharge analgesia prescribing guidelines has improved.
• Significant issues persist regarding safe storage, disposal, and management of unused pain medications.
• Further interventions are needed to address patient medication management post-discharge.