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Discharge Prescribing Protocol Decreases Opioids in Circulation and Does Not Increase Refills After Colorectal
Philip S Bauer1, Aneel Damle, Jonathan S Abelson
1Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, St. Louis, Missouri.
Diseases of the Colon and Rectum
|February 2, 2023
Summary
A new protocol reduced opioid prescriptions for colorectal surgery patients, decreasing community opioid supply without increasing refills. This addresses concerns about persistent opioid use post-surgery.
Area of Science:
- Colorectal Surgery
- Pain Management
- Opioid Prescribing Practices
Background:
- Postoperative persistent opioid use affects up to 10% of patients.
- Assessing opioid prescribing and patient utilization after colorectal surgery is crucial.
Discussion:
- Implemented a protocol to minimize postoperative opioid prescriptions.
- Discharged patients with 5 or 15 oxycodone 5 mg equivalents based on prior 24-hour usage.
- Evaluated prescribing and usage patterns via patient questionnaires.
Key Insights:
- Opioid-naive patients were prescribed fewer tablets post-protocol (median 15 vs. 30).
- Patients took significantly fewer prescribed opioids (median 10 tablets in both groups).
- Refill rates remained similar (13.8% vs. 18.8%), indicating no increased need.
Outlook:
- Further long-term studies are needed to evaluate persistent opioid use.
- The protocol effectively reduced overprescribing and community opioid burden.
- Potential for broader implementation in surgical settings to curb opioid misuse.
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