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A "just in time" educational intervention for opioid overprescribing in dialysis access surgery
Riley Brian1, Elizabeth Lancaster1, Jade Hiramoto1
1Department of Surgery, University of California, San Francisco, USA.
Background:
Despite widespread efforts to combat the opioid epidemic, an ongoing contributor to opioid misuse remains post-operative opioid overprescribing by residents. The goal of this study was to evaluate the impact of a low-cost, reproducible "just in time" intervention on opioid prescribing in dialysis access operations.
Methods:
Standardized opioid prescribing guidelines were emailed to residents on the vascular service on the first day of the rotation. Opioid prescriptions were reviewed for four years before and one year after this intervention. Wilcoxon rank-sum test and tests of proportions were used to compare groups.
Results:
Overall, 299 patients underwent dialysis access procedures. There was a decrease in patients discharged with opioids following the intervention from 58% to 36% (p = 0.003). For patients prescribed opioids, the median quantity decreased from 90 to 45 oral morphine equivalents (p = 0.03).
Conclusions:
This low-cost and timely learning intervention may be a useful adjunct to reduce post-operative opioid prescriptions.
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