Matthew Ziegelmann1, Jason Joseph2, Amy Glasgow3, Mark Tyson4, Raymond Pak5, Halena Gazelka6, Bradley Leibovich2, Elizabeth Habermann3, Matthew Gettman7. 1. Department of Urology, Mayo Clinic, Rochester, MN, USA. Electronic address: ziegelmann.matthew@mayo.edu. 2. Department of Urology, Mayo Clinic, Rochester, MN, USA. 3. The Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery Surgical Outcomes Program, Mayo Clinic, Rochester, MN, USA. 4. Department of Urology, Mayo Clinic, Scottsdale, AZ, USA. 5. Department of Urology, Mayo Clinic, Jacksonville, FL, USA. 6. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA. 7. Department of Urology, Mayo Clinic, Rochester, MN, USA. Electronic address: gettman.matthew@mayo.edu.
Abstract
BACKGROUND: We developed evidence-based guidelines for postoperative opioid prescribing after urologic surgery and assessed changes in prescribing after implementation. METHODS: Prescribing data for adults who underwent 21 urologic procedures were used to derive a four-tiered guideline for postoperative opioid prescribing. This was implemented on January 1, 2018, and prescribing patterns including quantity of opioids prescribed (oral morphine equivalents; OME) and refill rates were compared between patients undergoing surgery prior to (January-April, 2017; n equals 1732) and after (January-April, 2018; n equals1376) implementation. RESULTS: The median OME (IQR) prescribed was significantly lower for 2018 compared with 2017 [100 (0; 175) versus 150 (60; 225); p < .0001]. The median prescribed OME decreased in 14/21 procedures (67%). The refill rates did not significantly change. Guideline adherence rates after implementation, based on individual procedures, ranged from 33 to 95%. CONCLUSIONS: Fewer opioids were prescribed after implementing a prescribing guideline. Additional study is required to assess patient opioid utilization.
BACKGROUND: We developed evidence-based guidelines for postoperative opioid prescribing after urologic surgery and assessed changes in prescribing after implementation. METHODS: Prescribing data for adults who underwent 21 urologic procedures were used to derive a four-tiered guideline for postoperative opioid prescribing. This was implemented on January 1, 2018, and prescribing patterns including quantity of opioids prescribed (oral morphine equivalents; OME) and refill rates were compared between patients undergoing surgery prior to (January-April, 2017; n equals 1732) and after (January-April, 2018; n equals1376) implementation. RESULTS: The median OME (IQR) prescribed was significantly lower for 2018 compared with 2017 [100 (0; 175) versus 150 (60; 225); p < .0001]. The median prescribed OME decreased in 14/21 procedures (67%). The refill rates did not significantly change. Guideline adherence rates after implementation, based on individual procedures, ranged from 33 to 95%. CONCLUSIONS: Fewer opioids were prescribed after implementing a prescribing guideline. Additional study is required to assess patient opioid utilization.
Authors: Bruno Turcotte; Emma Jacques; Samuel Tremblay; Paul Toren; Yves Caumartin; Michele Lodde Journal: Can Urol Assoc J Date: 2022-08 Impact factor: 2.052
Authors: Allison Kirkegaard; Zachary Wagner; Louis T Mariano; Meghan C Martinez; Xiaowei Sherry Yan; Robert J Romanelli; Katherine E Watkins Journal: BMJ Open Date: 2022-09-19 Impact factor: 3.006