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Standardizing Opioids Prescribed at Discharge in Trauma Surgery
Claire H Seo1, Katherine L Howe2, Kelly B McAllister3
1School of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
The Journal of Surgical Research
|May 17, 2023
Summary
Implementing electronic medical record order sets significantly reduced opioid prescriptions for trauma patients. This intervention decreased morphine milligram equivalents (MME) at discharge, aiding in the fight against the opioid epidemic.
Area of Science:
- Trauma Surgery
- Pain Management
- Public Health
Background:
- Excessive opioid prescribing post-trauma contributes to the ongoing opioid epidemic.
- Standardizing discharge opioid quantities can improve prescribing habits and patient outcomes.
Purpose of the Study:
- To evaluate the impact of new electronic medical record (EMR) order sets on opioid prescribing practices for trauma patients.
- To determine if EMR order sets reduce the quantity of morphine milligram equivalents (MME) prescribed at discharge.
Main Methods:
- A quasi-experimental study was conducted at a Level 1 Trauma Center from January 2017 to March 2021.
- New EMR order sets with recommended discharge opioid quantities were implemented in November 2020.
- Opioid prescribing practices (MME at discharge) were compared between pre- and post-intervention cohorts.
Main Results:
- A significant reduction in median MME prescribed at discharge was observed post-intervention (112.5 to 75.0).
- Median inpatient MME usage also decreased significantly after intervention.
- Patients receiving ideal discharge opioid quantities showed the lowest opioid refill rates.
Conclusions:
- Implementing individualized EMR order sets effectively reduced discharge opioid quantities for trauma patients without adverse outcomes.
- Standardizing surgical prescribing through EMR order sets contributed to reduced inpatient opioid use.
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