Decreasing Postoperative Opioid Prescribing through Education

Lynn Nguyen; Stacey Bowlds; Christina Munford; Krista Miller; Timothy Finnegan; Eric Clayton; Murali Ranjani Behara; Christopher Senkowski

doi:10.1016/j.jsurg.2019.11.010

Decreasing Postoperative Opioid Prescribing through Education

Lynn Nguyen, Stacey Bowlds, Christina Munford, Krista Miller, Timothy Finnegan, Eric Clayton, Murali Ranjani Behara, Christopher Senkowski

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: To study how an educational intervention given to surgical residents affected postoperative opioid prescribing. To determine whether decreased opioid prescription amounts increased patients' rate of refills, emergency department visits, or readmissions.

DESIGN: Prospective sequential cohort study.

SETTING: Level 1 tertiary care center in Savannah, Georgia.

PARTICIPANTS: Opioid-naive patients who underwent general surgery (appendectomy, cholecystectomy, colectomy, hernia repair, lumpectomy, and mastectomy) between November 2017 and February 2018.

RESULTS: Over a 6 month period, morphine milligram equivalents (MME) prescribed after general surgery per patient was decreased by 21.8% on average, with the largest reductions seen after breast and gallbladder surgeries (38% and 25% respectively). Patients who underwent laparoscopic surgery were prescribed 18.3% fewer MME. There was no significant change in MME prescribed after open abdominal surgery. Smaller prescription amounts were not associated with an increased rate of opioid refills. There was no increase in pain-related calls to clinic offices, emergency department visits, or readmissions for pain.

CONCLUSION: After a single education intervention given to surgical residents, MME prescribed after common general surgeries can be decreased significantly without increasing rates of refills or utilization of care.

Original language	English
Pages (from-to)	615-620
Number of pages	6
Journal	Journal of surgical education
Volume	77
Issue number	3
DOIs	https://doi.org/10.1016/j.jsurg.2019.11.010
State	Published - 2020
Externally published	Yes

Keywords

Analgesics, Opioid/therapeutic use
Breast Neoplasms
Cohort Studies
Drug Prescriptions
Female
Georgia
Humans
Mastectomy
Pain, Postoperative/drug therapy
Practice Patterns, Physicians'
Prospective Studies

Access to Document

10.1016/j.jsurg.2019.11.010

Cite this

@article{cf974f0b13e4403ea6d5b64785f4c3cb,

title = "Decreasing Postoperative Opioid Prescribing through Education",

abstract = "OBJECTIVES: To study how an educational intervention given to surgical residents affected postoperative opioid prescribing. To determine whether decreased opioid prescription amounts increased patients' rate of refills, emergency department visits, or readmissions.DESIGN: Prospective sequential cohort study.SETTING: Level 1 tertiary care center in Savannah, Georgia.PARTICIPANTS: Opioid-naive patients who underwent general surgery (appendectomy, cholecystectomy, colectomy, hernia repair, lumpectomy, and mastectomy) between November 2017 and February 2018.RESULTS: Over a 6 month period, morphine milligram equivalents (MME) prescribed after general surgery per patient was decreased by 21.8% on average, with the largest reductions seen after breast and gallbladder surgeries (38% and 25% respectively). Patients who underwent laparoscopic surgery were prescribed 18.3% fewer MME. There was no significant change in MME prescribed after open abdominal surgery. Smaller prescription amounts were not associated with an increased rate of opioid refills. There was no increase in pain-related calls to clinic offices, emergency department visits, or readmissions for pain.CONCLUSION: After a single education intervention given to surgical residents, MME prescribed after common general surgeries can be decreased significantly without increasing rates of refills or utilization of care.",

keywords = "Analgesics, Opioid/therapeutic use, Breast Neoplasms, Cohort Studies, Drug Prescriptions, Female, Georgia, Humans, Mastectomy, Pain, Postoperative/drug therapy, Practice Patterns, Physicians', Prospective Studies",

author = "Lynn Nguyen and Stacey Bowlds and Christina Munford and Krista Miller and Timothy Finnegan and Eric Clayton and Behara, {Murali Ranjani} and Christopher Senkowski",

year = "2020",

doi = "10.1016/j.jsurg.2019.11.010",

language = "English",

volume = "77",

pages = "615--620",

journal = "Journal of surgical education",

issn = "1878-7452",

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TY - JOUR

T1 - Decreasing Postoperative Opioid Prescribing through Education

AU - Nguyen, Lynn

AU - Bowlds, Stacey

AU - Munford, Christina

AU - Miller, Krista

AU - Finnegan, Timothy

AU - Clayton, Eric

AU - Behara, Murali Ranjani

AU - Senkowski, Christopher

PY - 2020

Y1 - 2020

N2 - OBJECTIVES: To study how an educational intervention given to surgical residents affected postoperative opioid prescribing. To determine whether decreased opioid prescription amounts increased patients' rate of refills, emergency department visits, or readmissions.DESIGN: Prospective sequential cohort study.SETTING: Level 1 tertiary care center in Savannah, Georgia.PARTICIPANTS: Opioid-naive patients who underwent general surgery (appendectomy, cholecystectomy, colectomy, hernia repair, lumpectomy, and mastectomy) between November 2017 and February 2018.RESULTS: Over a 6 month period, morphine milligram equivalents (MME) prescribed after general surgery per patient was decreased by 21.8% on average, with the largest reductions seen after breast and gallbladder surgeries (38% and 25% respectively). Patients who underwent laparoscopic surgery were prescribed 18.3% fewer MME. There was no significant change in MME prescribed after open abdominal surgery. Smaller prescription amounts were not associated with an increased rate of opioid refills. There was no increase in pain-related calls to clinic offices, emergency department visits, or readmissions for pain.CONCLUSION: After a single education intervention given to surgical residents, MME prescribed after common general surgeries can be decreased significantly without increasing rates of refills or utilization of care.

AB - OBJECTIVES: To study how an educational intervention given to surgical residents affected postoperative opioid prescribing. To determine whether decreased opioid prescription amounts increased patients' rate of refills, emergency department visits, or readmissions.DESIGN: Prospective sequential cohort study.SETTING: Level 1 tertiary care center in Savannah, Georgia.PARTICIPANTS: Opioid-naive patients who underwent general surgery (appendectomy, cholecystectomy, colectomy, hernia repair, lumpectomy, and mastectomy) between November 2017 and February 2018.RESULTS: Over a 6 month period, morphine milligram equivalents (MME) prescribed after general surgery per patient was decreased by 21.8% on average, with the largest reductions seen after breast and gallbladder surgeries (38% and 25% respectively). Patients who underwent laparoscopic surgery were prescribed 18.3% fewer MME. There was no significant change in MME prescribed after open abdominal surgery. Smaller prescription amounts were not associated with an increased rate of opioid refills. There was no increase in pain-related calls to clinic offices, emergency department visits, or readmissions for pain.CONCLUSION: After a single education intervention given to surgical residents, MME prescribed after common general surgeries can be decreased significantly without increasing rates of refills or utilization of care.

KW - Analgesics, Opioid/therapeutic use

KW - Breast Neoplasms

KW - Cohort Studies

KW - Drug Prescriptions

KW - Female

KW - Georgia

KW - Humans

KW - Mastectomy

KW - Pain, Postoperative/drug therapy

KW - Practice Patterns, Physicians'

KW - Prospective Studies

U2 - 10.1016/j.jsurg.2019.11.010

DO - 10.1016/j.jsurg.2019.11.010

M3 - Article

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JO - Journal of surgical education

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