OBJECTIVE: We aimed to identify opioid prescribing practices across surgical specialties and institutions. BACKGROUND: In an effort to minimize the contribution of prescription narcotics to the nationwide opioid epidemic, reductions in postoperative opioid prescribing have been proposed. It has been suggested that a maximum of 7 days, or 200 mg oral morphine equivalents (OME), should be prescribed at discharge in opioid-naïve patients. METHODS: Adults undergoing 25 common elective procedures from 2013 to 2015 were identified from American College of Surgeons National Surgical Quality Improvement Program data from 3 academic centers in Minnesota, Arizona, and Florida. Opioids prescribed at discharge were abstracted from pharmacy data and converted into OME. Wilcoxon Rank-Sum and Kruskal-Wallis tests assessed variations. RESULTS: Of 7651 patients, 93.9% received opioid prescriptions at discharge. Of 7181 patients who received opioid prescriptions, a median of 375 OME (interquartile range 225-750) were prescribed. Median OME varied by sex (375 men vs 390 women, P = 0.002) and increased with age (375 age 18-39 to 425 age 80+, P < 0.001). Patients with obesity and patients with non-cancer diagnoses received more opioids (both P < 0.001). Subset analysis of the 5756 (75.2%) opioid-naïve patients showed the majority received >200 OME (80.9%). Significant variations in opioid prescribing practices were seen within each procedure and between the 3 medical centers. CONCLUSIONS: The majority of patients were overprescribed opioids. Significant prescribing variation exists that was not explained by patient factors. These data will guide practices to optimize opioid prescribing after surgery.
OBJECTIVE: We aimed to identify opioid prescribing practices across surgical specialties and institutions. BACKGROUND: In an effort to minimize the contribution of prescription narcotics to the nationwide opioid epidemic, reductions in postoperative opioid prescribing have been proposed. It has been suggested that a maximum of 7 days, or 200 mg oral morphine equivalents (OME), should be prescribed at discharge in opioid-naïve patients. METHODS: Adults undergoing 25 common elective procedures from 2013 to 2015 were identified from American College of Surgeons National Surgical Quality Improvement Program data from 3 academic centers in Minnesota, Arizona, and Florida. Opioids prescribed at discharge were abstracted from pharmacy data and converted into OME. Wilcoxon Rank-Sum and Kruskal-Wallis tests assessed variations. RESULTS: Of 7651 patients, 93.9% received opioid prescriptions at discharge. Of 7181 patients who received opioid prescriptions, a median of 375 OME (interquartile range 225-750) were prescribed. Median OME varied by sex (375 men vs 390 women, P = 0.002) and increased with age (375 age 18-39 to 425 age 80+, P < 0.001). Patients with obesity and patients with non-cancer diagnoses received more opioids (both P < 0.001). Subset analysis of the 5756 (75.2%) opioid-naïve patients showed the majority received >200 OME (80.9%). Significant variations in opioid prescribing practices were seen within each procedure and between the 3 medical centers. CONCLUSIONS: The majority of patients were overprescribed opioids. Significant prescribing variation exists that was not explained by patient factors. These data will guide practices to optimize opioid prescribing after surgery.
Authors: Heather A Lillemoe; Timothy E Newhook; Timothy J Vreeland; Elsa M Arvide; Whitney L Dewhurst; Elizabeth G Grubbs; Thomas A Aloia; Jean-Nicolas Vauthey; Jeffrey E Lee; Ching-Wei D Tzeng Journal: Ann Surg Oncol Date: 2019-04-01 Impact factor: 5.344
Authors: Abhiram R Bhashyam; Matthew Basilico; Michael J Weaver; Mitchel B Harris; Marilyn Heng Journal: J Orthop Trauma Date: 2019-04 Impact factor: 2.512
Authors: Avery Pullman; Ania Syrowatka; Alexandra Businger; Michael Sainlaire; Stuart Lipsitz; Tien Thai; Woongki Kim; David W Bates; Patricia Dykes Journal: AMIA Annu Symp Proc Date: 2021-01-25
Authors: Ania Syrowatka; Avery Pullman; Woongki Kim; Stuart R Lipsitz; Michael Sainlaire; Wenyu Song; Tien Thai; David W Bates; Patricia C Dykes Journal: AMIA Annu Symp Proc Date: 2021-01-25
Authors: Matthew C Hernandez; Eric J Finnesgard; Johnathon M Aho; Martin D Zielinski; Henry J Schiller Journal: J Gastrointest Surg Date: 2019-01-22 Impact factor: 3.452
Authors: Joe Habbouche; Jay Lee; Rena Steiger; James M Dupree; Caitlin Khalsa; Michael Englesbe; Chad Brummett; Jennifer Waljee Journal: JAMA Surg Date: 2018-12-01 Impact factor: 14.766