OPEN examines data, clinical practices and strategies to support better pain management, opioid stewardship, policy, treatment and care.
- Among opioid naïve Medicare patients aged 65 and older who underwent major/minor surgery, 53.8% of patients filled an opioid prescription within seven days of discharge.
- Opioid prescription size was largest for patients whose surgeons were early in practice (<7 years: 292 OMEs), with decreasing amounts of opioids filled among patients with surgeons who had been in practice longer (8-15 years: 279 OMEs; 16-25 years: 265 OMEs).
- In Michigan, surgical patients discharged from teaching hospitals fill significantly larger opioid prescriptions and have higher rates of high-risk prescribing compared with patients discharged from nonteaching hospitals.
- All hospitals, particularly teaching hospitals, should devote adequate resources to facilitating safe postoperative opioid prescribing.
- Advanced practice providers account for 1-in-5 postoperative opioid prescriptions.
- Postoperative opioid prescriptions written by advanced practice providers are 18% larger than those written by physicians.
- All providers should be involved in postoperative care to understand prescribing practices and identify barriers to reducing prescribing.
- It is crucial for surgeons to perform a series of preoperative assessments (check for history of substance abuse, previous overdose, past opioid prescriptions, comorbid conditions, etc.) in order to identify patients with an increased risk of opioid overdose.
- More surgeon involvement in research, evidence-based practice, and education will help to combat opioid misuse and overdose after surgery.