Opioid information pamphlet increases postoperative opioid disposal rates: a before versus after quality improvement study

Rose, Peter S.; Sakai, Jenni; Argue, Ruth; Froehlich, Kevin; Tang, Raymond

doi:10.1007/s12630-015-0502-0

Cited by 66 publications

(54 citation statements)

References 15 publications

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“…Steroids have also been shown to be a promising component of multimodal analgesia, most likely through anti‐inflammatory effects . Additionally, preoperative education on pain management may decrease postoperative opioid consumption by setting patient expectations for treatment outcomes . Lastly, effective inpatient multimodal pain regimens may decrease the need for opioids in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Postoperative opioid‐prescribing practices in otolaryngology: A multiphasic study

Dang

Duffy

et al. 2019

The Laryngoscope

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Objectives In otolaryngology, postoperative pain management lacks evidence‐based guidelines. We designed a prospective, multiphasic study aimed to develop evidence‐based guidelines for postoperative pain management within our institution. In this first phase of our project, we investigated opioid prescription and consumption as well as pain trends for common otolaryngologic procedures. Methods Patients (n = 161) who underwent procedures between July 2018 and February 2019 were surveyed on their postoperative opioid usage and pain from day of discharge to first clinic visit. Opioid prescriptions were converted to standardized units of morphine milligram equivalents (MME). The procedures selected for analysis were parathyroidectomy/thyroidectomy, parotidectomy, sialendoscopy, and transoral robotic surgery resection (TORS). Results In total, 19,748 MME were prescribed: 8,588 MME (43.5%) were used, leaving 11,159 MME (56.5%) unused. TORS average MME used: 221 ± 227; total MME unused: 38%. Sialendoscopy average MME used: 31 ± 46; total MME unused: 67%. Parathyroidectomy/thyroidectomy average MME used: 30 ± 37; total MME unused: 66%. Parotidectomy average MME used: 43 ± 53; total MME unused: 65%. Male gender, smoking (current and former), and psychiatric medication use were positive predictors of opioid consumption in postoperative patients (P < 0.001). Conclusion At our institution, over 50% of prescribed postoperative opioids went unused. This was most pronounced for nonmucosal surgeries. Postoperative pain management should account for this to minimize unnecessary opioid prescriptions. Based on our findings and review of current literature, we are in the process of developing prescribing recommendations to be implemented within our institution. Level of Evidence 2 Laryngoscope, 130:659–665, 2020

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Section: Discussionmentioning

confidence: 99%

Postoperative opioid‐prescribing practices in otolaryngology: A multiphasic study

Dang

Duffy

et al. 2019

The Laryngoscope

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“…The educational program was designed to address the inadequate knowledge regarding opioids demonstrated by our patients in a previous survey. Several studies have shown various levels of success using different modalities to improve patient education and other outcomes . Our group decided to use a pamphlet as our EM (along with personalized education by our PC clinic medical staff) because of its straightforwardness, ease of implementation, and reproducibility.…”

Section: Discussionmentioning

confidence: 99%

The Impact of an Educational Program on Patient Practices for Safe Use, Storage, and Disposal of Opioids at a Comprehensive Cancer Center

et al. 2017

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Background. Improper use, storage, and disposal of prescribed opioids can lead to diversion or accidental poisoning. Our previous study showed a large proportion of cancer patients have unsafe opioid practices. Our objective was to determine whether an improvement occurred in the patterns of use, storage, and disposal of opioids among cancer outpatients after the implementation of a patient educational program. Patients and Methods. Our palliative care (PC) clinic provides every patient with educational material (EM) on safe opioid use, storage, and disposal every time they receive an opioid prescription. We prospectively assessed 300 adult cancer outpatients receiving opioids in our PC clinic, who had received the EM, and compared them with 300 patients who had not received the EM. The previously used surveys pertaining to opioid use, storage, and disposal were administered, and

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“…This highlights the important role that consistent and simple education initiatives play in improving safe opioid practices in targeted patients . In a similar study surveying adult patients who had undergone hip and knee replacement surgery, providing education pamphlets showed improvement in the number of patients who practiced proper disposal but no improvement in safe storage practice . One randomized controlled trial looking into the impact of an educational intervention that included education materials on hydrocodone, followed by phone calls conducted 4 to 7 days after the visit to assess patient knowledge of the drug, reported that this intervention improved knowledge about the drug and reduced the incidence of driving while on the medication .…”

Section: Measures To Address Opioid Use Storage and Disposal Issuesmentioning

confidence: 99%

Safe Opioid Use, Storage, and Disposal Strategies in Cancer Pain Management

Reddy

Cruz

2019

The Oncologist

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Opioids are required by a majority of patients with advanced cancer. Oncologists and palliative care clinicians are faced with the challenge of safely prescribing opioids in the current environment of an opioid crisis. Many patients with cancer use opioids unsafely, store them in unsecure locations, and do not dispose of unused opioids, leading to increased availability of these opioids for others to misuse. More than 50% of people who misuse opioids obtain the drugs from a friend or relative with or without their consent. Patient and provider education has been shown to improve safe opioid use, promote secure storage, and also increase disposal of unused opioids safely in drug take‐back programs that are now widely available. This article highlights the importance of patient education and cautious opioid prescribing in patients with cancer. Implications for Practice The current opioid crisis makes it challenging to effectively manage cancer pain. Providers play a prominent role in minimizing opioid misuse. Cautious prescribing with limits enforced on the quantity of opioids prescribed, close follow‐up, and consistent and frequent provision of opioid education are a must. Evidence points to the impact of patient education in promoting safety around opioid use. Most people who misuse prescription opioids obtain them from family or friends. Storing opioids in the open or not disposing of unused opioids increases the availability of these opioids for misuse by others. The importance of not sharing, always locking up, and disposing of unused and expired opioids must be highlighted as part of the opioid education that must be delivered every time that opioids are prescribed. Information about local drug take‐back programs may also help increase disposal of unused opioids.

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Opioid information pamphlet increases postoperative opioid disposal rates: a before versus after quality improvement study

Cited by 66 publications

References 15 publications

Postoperative opioid‐prescribing practices in otolaryngology: A multiphasic study

Postoperative opioid‐prescribing practices in otolaryngology: A multiphasic study

The Impact of an Educational Program on Patient Practices for Safe Use, Storage, and Disposal of Opioids at a Comprehensive Cancer Center

Safe Opioid Use, Storage, and Disposal Strategies in Cancer Pain Management

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