Postoperative Opiate Use in Urological Patients: A Quality Improvement Study Aimed at Improving Opiate Disposal Practices

Cabo, Jackson; Hsi, Ryan S.; Scarpato, Kristen R.

doi:10.1016/j.juro.2018.09.052

Cited by 40 publications

(30 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nearly half the pills prescribed to the eight‐ and four‐pill cohorts were excess (45.9% vs 48.5%) and most were kept for later (72.7% vs 86.5%). This is consistent with other recent studies on opioid prescriptions after major urological surgeries which found that 60%‐80% of prescription opioids went unused and were kept by the patients …”

Section: Discussionsupporting

confidence: 92%

Decreasing postoperative opioid use while managing pain: A prospective study of men who underwent scrotal surgery

2020

View full text Add to dashboard Cite

Objective To compare postoperative pain control among men who received different quantities of narcotic prescriptions following scrotal surgery. We hypothesized that men receiving eight vs four pills of acetaminophen 300 mg/codeine 30 mg there would be no significant difference in mean pain following scrotal and inguinal surgery. Patients and methods In this prospective, open‐label study, men who underwent scrotal surgery received eight or four acetaminophen 300 mg/codeine 30 mg pills. Men were encouraged to take scheduled non‐steroidal anti‐inflammatory drugs (NSAIDs), apply ice on the incision, and take acetaminophen 300 mg/codeine 30 mg as needed for breakthrough pain. Men were evaluated within 1‐2 weeks after surgery. Statistical analysis was performed using Microsoft Excel and Stata/IC 15.1. Results A total of eighty‐seven men met inclusion criteria, fifty‐four men received eight acetaminophen/codeine pills, and thirty‐three men received four pills. There was no significant difference in mean pain score (0‐10) of men receiving eight pills vs four pills in the week after surgery (3.6 ± 1.9 vs 3.3 ± 1.8, P = .5004). Of men who used NSAIDs and ice, 93.5% and 92.3% found them to be moderately or very helpful. Conclusion Reducing the total prescription of combined narcotic/non‐narcotic medication is not associated with increased postoperative pain in patients undergoing scrotal/inguinal surgery. There was no difference in postoperative pain in men taking eight or four acetaminophen 300 mg/codeine 30 mg pills. A limited prescription of eight or four pills was adequate for pain control in the majority of men who underwent scrotal surgery. NSAIDs and ice were found to be useful adjuncts for pain relief by those who used them.

show abstract

Section: Discussionsupporting

confidence: 92%

Decreasing postoperative opioid use while managing pain: A prospective study of men who underwent scrotal surgery

2020

View full text Add to dashboard Cite

show abstract

“…found that distribution of a handout to urology patients did not change the proportion of patients disposing of opioids appropriately (8% to 9%). 9 Current Centers for Disease Control and Prevention guidelines recommend disposal of excess opioids by flushing down the toilet, mixing with cat litter or coffee grounds, or returning through a community/pharmacy take-back program. 15 Each of these approaches has inherent limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Without interventions, only 4%-59% of patients plan to or actually dispose of excess opioids after surgery, and only 4%-9% of patients do so in an FDA-approved fashion. [3][4][5][6][7][8] Interventions based on patient education have shown mixed effects with some studies showing no impact on appropriate disposal rates 9 and others showing positive benefits. 2,10,11 We conducted a single-institution prospective observational pilot study to determine 1) how postsurgical patients manage leftover opioids and 2) if the distribution of free home disposal packets and educational handouts increased the likelihood that patients would appropriately dispose of their leftover opioids.…”

Section: Introductionmentioning

confidence: 99%

Home Disposal Kits for Leftover Opioid Medications After Surgery: Do They Work?

Stokes

Kim

Jacobs

et al. 2020

Journal of Surgical Research

View full text Add to dashboard Cite

“…Among studies with no intervention, the rate of opioid disposal was 4.9% to 46.5% [1,2,4,9,11,16,29]. There was an intervention group in 9 (56%) studies, with rate of opioid disposal ranging from 22% to 87% [6,7,17,18,20,23,28,32,34]. In 3 studies, the intervention was an opioid disposal kit or bag [6,23,34].…”

Section: Opioid Disposal Ratesmentioning

confidence: 99%

Postoperative Disposal of Unused Opioids: A Systematic Review

et al. 2021

View full text Add to dashboard Cite

Introduction: Opioid misuse and overprescription have contributed to a national public health crisis in the United States. Postoperatively, patients are often left with unused opioids, which pose a risk for diversion if not appropriately disposed of. Patients are infrequently provided instructions on safe disposal methods of surplus opioids. Purpose: We sought to determine the current rates of disposal of unused opioids and the reported disposal mechanisms for unused opioids that were prescribed for acute postoperative pain control. Methods: A systematic review was performed of the PubMed, Cochrane, and Embase databases for relevant articles from their earliest entries through October 2, 2019. We used the search terms “opioid” or “narcotic” and “disposal” and “surgery.” Studies were considered for inclusion if they reported the rate of disposal of unused opioids following surgery. A screening strategy was used to identify relevant articles using Covidence. For studies meeting inclusion criteria, relevant information was extracted. Results: Sixteen studies met inclusion criteria. We found that surplus opioid disposal rates varied widely, from 4.9% to 87.0%. Among studies with no intervention (opioid disposal education or drug disposal kit/bag), rates of opioid disposal ranged from 4.9% to 46.5%. While 7 studies used opioid disposal education as an intervention, only 3 showed a significant increase in surplus opioid disposal compared with standard care. All 3 studies that used an opioid disposal kit or bag as an intervention demonstrated significant increases in opioid disposal. Conclusions: Baseline rates of surplus opioid disposal are relatively low in the postoperative setting. Our findings suggest that opioid disposal kits significantly increase rates of surplus opioid disposal postoperatively. Further research, including a large-scale cost-benefit analysis, will be necessary prior to recommending widespread implementation of drug disposal kits or bags.

show abstract

Postoperative Opiate Use in Urological Patients: A Quality Improvement Study Aimed at Improving Opiate Disposal Practices

Cited by 40 publications

References 0 publications

Decreasing postoperative opioid use while managing pain: A prospective study of men who underwent scrotal surgery

Decreasing postoperative opioid use while managing pain: A prospective study of men who underwent scrotal surgery

Home Disposal Kits for Leftover Opioid Medications After Surgery: Do They Work?

Postoperative Disposal of Unused Opioids: A Systematic Review

Contact Info

Product

Resources

About