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4 Evidence-based Reasons To Improve Opioid Prescribing Practices After Surgery

EVIDENCE SHOWS:

Greater than 70% of prescribed opioids are not used 1,2

Reducing opioid prescribing improves the safety for patients, families, and communities 

  • Postoperative opioid prescribing varies significantly 1  
  • Prescription size was the strongest predictor of patient consumption 3  
  • Evidence-based opioid prescribing guidelines for the perioperative period are needed to enable tailored prescribing for patients and reduce excess opioid pills within communities 4  

 

No Correlation between patient satisfaction scores and amount of opioid prescribed 5  

Prescribing more opioids does not improve patient satisfaction

  • Patients who were prescribed fewer opioids reported using fewer opioids with no change in pain scores 6
  • Prescribers can feel empowered to reduce their initial opioid prescription without impacting patient satisfaction 5  

 

No Correlation between probability of refill and amount of opioid prescribed 7  

Prescribing fewer opioids initially does not correlate with an increase in refill requests

  • Prescribers could prescribe smaller opioid prescriptions without influencing the probability of a refill request 7  
  • Implementation of evidence-based prescribing guidelines reduced post-laparoscopic cholecystectomy opioid prescribing by 63% without increasing the need for medication refills 6  

 

6-10% of surgical patients develop new persistent opioid use 8,9,10

New persistent opioid use is one of the most common surgical complications

  • Many patients continue to use their opioids for reasons other than surgical pain 9,10
  • New persistent opioid use after surgery is an underappreciated surgical complication that warrants increased attention 8,9,10

Additional Resources:

OPEN Prescribing Recommendations: https://michigan-open.org/prescribing-recommendations/
Healthcare Professional Resources: https://michigan-open.org/healthcare-professionals/

References:

  1. Hill, M. Ann Surg. 2017;265(4):709-714.
  2. Bicket, MC. JAMA Surg. 2017;152(11):1066-1071.
  3. Howard, R. JAMA Surg. 2018. DOI:10.1001/jamasurg.2018.4234.
  4. Waljee, JF. Ann Surg. 2017;265(4): 728-730.
  5. Lee, JS. JAMA Surg. 2017;317(19): 2013-2015.
  6. Howard, R. JAMA Surg. 2018;153(3): 285-287.
  7. Sekhri S. Ann Surg. 2018;268(2): 271-276.
  8. Lee, JS. J Clin Oncol. 2017;35(36): 4042-4049.
  9. Goesling J. Pain. 2016;157(6):1259-1265.
  10. Brummett, CM. JAMA Surg. 2017. DOI:10.1001/jamasurg.2017.0504.

Cite this work:


OPEN: Opioid Prescribing Engagement Network (2022). 4 Evidence-Based Reasons to Improve Opioid Prescribing Practices After Surgery. Retrieved from https://doi.org/10.56137/OPEN.000013

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