2022
DOI: 10.1097/pts.0000000000001088
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Evaluation of Policies Limiting Opioid Exposure on Opioid Prescribing and Patient Pain in Opioid-Naive Patients Undergoing Elective Surgery in a Large American Health System

Abstract: ObjectivesOverprescribing to opioid-naive surgical patients substantially contributes to opioid use disorders, which have become increasingly prevalent. Opioid stewardship programs (OSPs) within healthcare settings provide an avenue for introducing interventions to regulate prescribing. This study examined the association of OSP policies limiting exposure on changes in surgery-related opioid prescriptions and patient pain.MethodsWe evaluated policies implemented by an OSP in a large American healthcare system … Show more

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Cited by 1 publication
(5 citation statements)
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“…That said, there is generally a lack of consistent guidelines for opioid prescribing post-surgery, particularly for opioidnaïve patients, with studies utilizing a variety of dosages (e.g., 50-2000 MME) or any dosage to examine the association between dose and later use [18,19,22,25,26]. Whereas 90 MME is considered high-dose prescribing, it is still lower than that examined in some studies, and our study detected a significant difference in the likelihood of a refill between ≤ 90 MME and >90 MME, demonstrating the need for guidelines for opioid-naïve patients [4,7,[18][19][20][21][22]. Additionally, there has been a focus in the literature on opioid prescriptions for chronic or pre-operative pain and the risk of continued use, while surgical patients receive the greatest amount of potent opioids [6,7,10,19,23].…”
Section: Discussionmentioning
confidence: 60%
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“…That said, there is generally a lack of consistent guidelines for opioid prescribing post-surgery, particularly for opioidnaïve patients, with studies utilizing a variety of dosages (e.g., 50-2000 MME) or any dosage to examine the association between dose and later use [18,19,22,25,26]. Whereas 90 MME is considered high-dose prescribing, it is still lower than that examined in some studies, and our study detected a significant difference in the likelihood of a refill between ≤ 90 MME and >90 MME, demonstrating the need for guidelines for opioid-naïve patients [4,7,[18][19][20][21][22]. Additionally, there has been a focus in the literature on opioid prescriptions for chronic or pre-operative pain and the risk of continued use, while surgical patients receive the greatest amount of potent opioids [6,7,10,19,23].…”
Section: Discussionmentioning
confidence: 60%
“…Alternative non-opioid medications and opioid prescribing protocols may be of use to minimize risks without jeopardizing pain management. To give some examples, a shift to use of ketamine instead of opioids during surgery, a decrease in the availability of opioid dosage vials, EHR notifications to alert prescribers to high doses, and limitations to the duration of post-surgery prescriptions have been shown to be effective at reducing the MME prescribed post-surgery without compromising patient pain [4]. However, in an evaluation of opioid-prescribing practices, such policies did not show an association with fewer refills of opioid prescriptions post-surgery [4].…”
Section: Discussionmentioning
confidence: 99%
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