Post-Operative Order Set Decreases Opioid Prescriptions and Increases Efficiency.

Area of Science:

• Urology
• Pain Management
• Health Informatics

Background:

• Opioid addiction is a critical public health issue.
• Post-operative opioid overprescribing contributes to the crisis.
• Electronic Medical Record (EMR) systems offer potential solutions.

Purpose of the Study:

• To develop and implement an EMR-based protocol to reduce post-operative opioid prescribing for minor urologic procedures (MUOs).
• To streamline the opioid ordering process.
• To maintain effective pain control for patients.

Main Methods:

• An EMR order set was designed to minimize opioid prescriptions.
• Prescribing practices for MUOs were compared across three 6-week periods: pre-implementation and two post-implementation phases.
• The study analyzed opioid prescription rates and morphine milligram equivalents (MME).

Main Results:

• Opioid prescribing decreased from 91.7% pre-implementation to 44.2% post-implementation and 75.0% long-term (P < .0001).
• Mean MME prescribed dropped from 81.52 units pre-implementation to 38.74 units post-implementation and 24.21 units long-term (P < .0001).
• The order set implementation led to a substantial reduction in opioid use.

Conclusions:

• Integrating an EMR post-operative prescribing order set significantly reduced opioid prescribing after MUOs.
• The protocol streamlined the ordering process, enhancing efficiency.
• This approach effectively addresses opioid overprescribing while managing patient pain.