Lumpectomy Patients are at Highest Risk for Opioid Overprescription: A Comparison Between Practice Patterns and OPEN...

Area of Science:

• Oncology
• Pain Management
• Public Health

Background:

• The opioid epidemic, worsened by COVID-19, necessitates addressing excessive opioid prescribing.
• Nearly 25% of opioid-related fatalities involve prescribed opioids.
• Postoperative opioid prescribing requires alignment with national guidelines.

Purpose of the Study:

• To align local opioid prescribing practices with national guidelines for non-metastatic breast cancer patients.
• To analyze opioid prescribing patterns in breast cancer surgery patients.

Main Methods:

• Single-institution analysis of non-metastatic breast surgery patients (April 2020-July 2021).
• Defined 'overprescription' as discharge opioid quantity exceeding Michigan OPEN recommendations.
• Identified risk factors for opioid overprescription using univariable and multivariable analyses.

Main Results:

• 52% of 464 patients were overprescribed opioids; 74% of lumpectomy patients and 90% of those with axillary surgery received excess opioids.
• Mastectomy patients ( < 25%) were overprescribed less frequently.
• Discharge opioid quantity did not correlate with inpatient needs (r=0.024, p=0.604); age, smoking, and surgery duration were associated with higher prescribed amounts.

Conclusions:

• Patients undergoing less invasive breast surgery face a high risk of opioid overprescription.
• Current prescribing patterns deviate from national guidelines and patient requirements.
• Future efforts will focus on guideline adherence and tailored discharge protocols.