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Reducing Opioid Prescribing after Cesarean Delivery by Utilizing a Tailored Opioid Prescribing Algorithm
Christine P McKenzie1, Lacey E Straube1, Carolyn M Webster2
1Division of Obstetric Anesthesia, Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina.
American Journal of Perinatology
|September 29, 2023
Summary
A tailored opioid prescribing algorithm significantly reduced the number of opioid tablets prescribed after cesarean delivery. This approach also increased the number of patients discharged without an opioid prescription, promoting safer opioid use.
Area of Science:
- Obstetrics and Gynecology
- Pain Management
- Pharmacology
Background:
- Safe opioid prescribing is a growing concern in healthcare systems.
- Minimizing opioid overprescription requires established best practices.
- Cesarean delivery patients are a key population for evaluating opioid prescribing strategies.
Purpose of the Study:
- To evaluate the impact of a tailored opioid prescribing algorithm on prescription quantities.
- To assess the algorithm's effectiveness in reducing opioid use post-cesarean delivery.
- To determine if tailored prescribing influences the rate of discharge without opioid prescriptions.
Main Methods:
- Development of a tailored opioid prescribing algorithm based on inpatient opioid use.
- Retrospective analysis of opioid prescriptions 3 months pre- and post-algorithm implementation.
- Primary outcome: number of oxycodone 5-mg tablets prescribed; secondary outcomes: patient satisfaction and unused tablets via survey.
Main Results:
- Median oxycodone tablets prescribed decreased from 20 to 5 (p < 0.0001) post-implementation.
- For patients with no prior opioid use, median prescriptions dropped from 20 to 0 (p < 0.0001).
- Proportion of patients discharged without opioids increased from 7% to 35% (OR 6.9).
Conclusions:
- Tailored opioid prescribing algorithms effectively reduce dispensed opioid quantities.
- This strategy increases the likelihood of patients being discharged without opioid prescriptions.
- Personalized prescribing based on actual patient need is a viable approach to combat opioid overprescription.
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