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Implementation of Electronic Medical Record Interventions to Maximize Opioid Disposal after Surgery in Routine

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Implementing electronic health record interventions significantly boosted excess opioid disposal rates post-surgery. Combining information sheets, patient portal reminders, and provider discussions achieved over 90% disposal, reducing misuse risks.

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Area of Science:

  • Medical Practice
  • Public Health
  • Pharmacology

Background:

  • Postoperative patients often retain excess opioids, increasing risks of misuse and dependency.
  • Current guideline-directed opioid prescribing does not fully address leftover medication management.
  • The effectiveness of routine clinical interventions in improving opioid disposal rates remains under investigation.

Purpose of the Study:

  • To evaluate the impact of integrated electronic medical record (EMR) interventions on excess opioid disposal rates.
  • To determine if routine clinical practice adjustments can enhance safe disposal of unused postoperative medications.
  • To compare disposal rates before and after the implementation of specific EMR-based interventions.

Main Methods:

  • A comparative study involving adult patients receiving postoperative opioid prescriptions across multiple surgical departments.
  • Interventions included providing opioid disposal information sheets, EMR-based patient portal reminders, and provider alerts for postoperative visits.
  • Disposal rates were compared between a preintervention group (n=453) and an intervention group (n=545), with follow-up calls 1-3 months post-operation.

Main Results:

  • The study achieved a 70% response rate for opioid disposal outcomes (699/998 patients).
  • Excess opioids were reported by 54% (375/699) of patients.
  • The percentage of patients disposing of excess opioids increased significantly from 30% preintervention to 83% postintervention (p < 0.00001).

Conclusions:

  • Routine clinical practice interventions, easily integrated into the EMR, can substantially increase postoperative opioid disposal rates.
  • Combining educational materials, patient portal reminders, and provider discussions during postoperative visits can achieve over 90% opioid disposal.
  • These findings support the widespread adoption of EMR-integrated strategies to mitigate risks associated with excess opioid medications.