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Prospective Evaluation of a Tiered Opioid Prescribing Guideline for Inpatient Colorectal Operations.
Meyer, David C; Hill, Susanna S; Pavao, Richard; Resnick, Adam J; Purkayastha, Ayan; Davids, Jennifer S; Sturrock, Paul R; Maykel, Justin A; Alavi, Karim.
Afiliación
  • Meyer DC; Division of Colon and Rectal Surgery, University of Massachusetts Medical School,Worcester, MA; and.
  • Hill SS; Division of Colon and Rectal Surgery, University of Massachusetts Medical School,Worcester, MA; and.
  • Pavao R; Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, University of Massachusetts Medical School, Worcester, MA.
  • Resnick AJ; Division of Colon and Rectal Surgery, University of Massachusetts Medical School,Worcester, MA; and.
  • Purkayastha A; Division of Colon and Rectal Surgery, University of Massachusetts Medical School,Worcester, MA; and.
  • Davids JS; Division of Colon and Rectal Surgery, University of Massachusetts Medical School,Worcester, MA; and.
  • Sturrock PR; Division of Colon and Rectal Surgery, University of Massachusetts Medical School,Worcester, MA; and.
  • Maykel JA; Division of Colon and Rectal Surgery, University of Massachusetts Medical School,Worcester, MA; and.
  • Alavi K; Division of Colon and Rectal Surgery, University of Massachusetts Medical School,Worcester, MA; and.
Ann Surg ; 277(3): e561-e568, 2023 03 01.
Article en En | MEDLINE | ID: mdl-34171859
OBJECTIVE: This study sought to prospectively validate an institutional prescribing guideline based on previously defined opioid consumption patterns following inpatient colorectal operations. BACKGROUND: In light of the opioid epidemic, reducing excess prescription quantities is key while still tailoring to patient needs. METHODS: This is a cohort study of elective colorectal operations (colectomies, proctectomies, and ostomy reversals) at a single tertiary care medical center. Opioid prescribing and consumption patterns [quantified as Equianalgesic 5 mg Oxycodone Pills (EOP)] were compared before and after adoption of a tiered opioid prescribing guideline. Tiers were divided based on opioid consumption in the 24 hours before discharge: Tier 1 (0 EOP), Tier 2 (0.1-3 EOP), and Tier 3 (>3 EOP). Our guideline recommended maximum prescriptions of 0 EOP for Tier 1, 12 EOP for Tier 2, and 30 EOP for Tier 3. Results: The study included 100 patients before and 101 after guideline adoption. Demographic and operative characteristics were similar between cohorts. Guideline adherence was 85%. Overall, there was a 41%reduction in mean prescription quantity and 53% reduction in excess pills per prescription. No change in opioid consumption or refill rates was observed. CONCLUSIONS: Adoption of a tiered opioid prescribing guideline significantly reduced opioid prescription quantity with no change in consumption or refill rates. Standardization of discharge prescriptions based on patient consumption in the 24 hours before discharge may be an important step toward minimizing excess prescribing.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Analgésicos Opioides Tipo de estudio: Evaluation_studies / Guideline / Observational_studies Límite: Humans Idioma: En Revista: Ann Surg Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Analgésicos Opioides Tipo de estudio: Evaluation_studies / Guideline / Observational_studies Límite: Humans Idioma: En Revista: Ann Surg Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos