Comparison of prescribing patterns before and after implementation of evidence-based opioid prescribing guidelines for the postoperative urologic surgery patient - 20/06/20
, Jason Joseph a, Amy Glasgow d, Mark Tyson b, Raymond Pak c, Halena Gazelka e, Bradley Leibovich a, Elizabeth Habermann d, Matthew Gettman a Abstract |
Background |
We developed evidence-based guidelines for postoperative opioid prescribing after urologic surgery and assessed changes in prescribing after implementation.
Methods |
Prescribing data for adults who underwent 21 urologic procedures were used to derive a four-tiered guideline for postoperative opioid prescribing. This was implemented on January 1, 2018, and prescribing patterns including quantity of opioids prescribed (oral morphine equivalents; OME) and refill rates were compared between patients undergoing surgery prior to (January–April, 2017; n equals 1732) and after (January–April, 2018; n equals1376) implementation.
Results |
The median OME (IQR) prescribed was significantly lower for 2018 compared with 2017 [100 (0; 175) versus 150 (60; 225); p < .0001]. The median prescribed OME decreased in 14/21 procedures (67%). The refill rates did not significantly change. Guideline adherence rates after implementation, based on individual procedures, ranged from 33 to 95%.
Conclusions |
Fewer opioids were prescribed after implementing a prescribing guideline. Additional study is required to assess patient opioid utilization.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We created a tiered-guideline for opioid prescribing after urologic surgery. |
• | Fewer opioids were prescribed as a result of guideline implementation. |
• | Despite this, refill rates remained stable. |
• | Further work is necessary to increase guideline adherence. |
Keywords : Opioids, Postoperative, Pain, Guidelines, Epidemic
Plan
Vol 220 - N° 2
P. 499-504 - août 2020 Retour au numéro
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