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Postoperative Prescribing Practices Following Gynecologic Surgery.

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This summary is machine-generated.

An educational intervention did not decrease opioid prescriptions for gynecologic surgery patients, despite evidence of overprescribing. Resident-reported prescribing differed from actual practices, indicating a need for further study into opioid stewardship.

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Area of Science:

  • Obstetrics and Gynecology
  • Pain Management
  • Public Health

Background:

  • Opioid prescriptions for postoperative pain often exceed patient needs in the US, contributing to the opioid epidemic.
  • Preintervention data revealed gynecologic surgery patients received double the opioids they consumed.

Purpose of the Study:

  • To evaluate if an educational intervention, recommending opioid prescriptions based on actual postoperative use, reduces gynecologic surgeons' prescribing.
  • To address the discrepancy between prescribed and consumed opioids in gynecologic surgery.

Main Methods:

  • An educational intervention was implemented in January 2021, providing prescribing recommendations based on patient needs.
  • Postintervention chart reviews and resident surveys assessed changes in opioid prescribing practices.
  • Descriptive statistics were used to compare pre- and postintervention phases.

Main Results:

  • Opioid prescribing (in morphine milligram equivalents) showed minimal change for most gynecologic procedures after the intervention.
  • Median MME for vaginal hysterectomy decreased from 150 to 112.5; vaginal surgery without hysterectomy decreased from 75 to 54.
  • No change in median MME for laparoscopic hysterectomy or laparoscopic surgery without hysterectomy; zero for hysteroscopy and D&C in both phases.
  • Residents surveyed reported lower prescribing amounts than their actual practices.

Conclusions:

  • Educational interventions did not alter gynecologic surgeons' opioid prescribing habits, despite awareness of overprescribing.
  • A significant difference exists between actual and self-reported opioid prescribing by residents.
  • Further investigation is needed to understand prescribing behavior and improve opioid stewardship.