6-10% of surgical patients become new persistent users (a significant surgical complication).
Q: How likely is persistent use after surgery?
- Approximately 6-10% of opioid naïve (before surgery) patients continue to use opioids more than three months after surgery. (references 7, 8, 9)
- Many patients continue to use their opioids for reasons other than surgical pain. (references 7, 9)
- New persistent opioid use after surgery is an underappreciated surgical complication that warrants increased attention. (references 7, 8, 9)
No correlation between probability of refill and amount of opioid prescribed.
Q: Will patients request more prescription refills if initially prescribed fewer opioids?
- The probability of a patient refilling a post operative opioid prescription was not corelated with their initial prescription amount. (reference 10)
- Prescribers could prescribe smaller opioid prescriptions without influencing the probability of a refill request. (reference 10)
- Implementation of evidence-based prescribing guidelines reduced post-laparoscopic cholecystectomy opioid prescribing by 63% without increasing the need of medication refills.
Greater than 70% of prescribed opioids go unused.
Q: Why are prescribers being asked to change their opioid prescribing practices?
- Postoperative opioid prescribing varies significantly. (reference 1)
- Greater than 70% of prescribed pills went unused by patients. (references 1, 2)
- Patients who were prescribed fewer opioids reported using fewer opioids with no change in pain scores. (reference 3)
- Evidence-based opioid prescribing guidelines for the perioperative period are needed to enable tailored prescribing and reduce the excess of opioid pills within patients’ communities. (reference 4)
- Prescription size was the strongest predictor of patient consumption. (reference 5)
No correlation between patient satisfaction and amount of opioids prescribed.
Q: Will patient satisfaction scores be impacted by prescribing fewer opioids?
- No correlation was found between the HCAHPS pain measures and postoperative opioid prescribing. (reference 6)
- Prescribers can feel empowered to reduce their initial opioid prescription without impacting patient satisfaction. (reference 6)