John M Myrga1, Liam C Macleod2, Jathin Bandari3, Bruce L Jacobs3, Benjamin J Davies3. 1. University of Pittsburgh School of Medicine, Department of Urology, Pittsburgh, PA. Electronic address: myrgajm@upmc.edu. 2. Asante Medical Center, Medford, OR. 3. University of Pittsburgh School of Medicine, Department of Urology, Pittsburgh, PA.
Abstract
OBJECTIVE: To examine the effectiveness of the introduction of the Pennsylvania Prescription Drug Monitoring Program (PDMP) on discharge postoperative opioid prescriptions in patients undergoing major urologic procedures within a large single tertiary care hospital. Opioids have historically been prescribed to control postoperative pain, but with growing concern regarding opioid overdose, misuse, and diversion, measures have been introduced to curb opioid prescribing. Numerous states have introduced PDMP programs as a method to search patients' prior opioid prescriptions. These programs have reduced opioid prescriptions in emergency department and outpatient settings, but their effectiveness, and the use of a prescriber query mandate, in reducing postoperative opioid prescribing has not been established. METHODS: We identified 582 patients who underwent major prostate or renal surgery between July 1st 2016 and June 30th 2017 at a single large academic hospital. We examined prescribing trends in both opioid naive and opioid tolerant patients measuring 5mg oxycodone equivalents before and after a PDMP query was mandated on January 1st 2017. RESULTS: There was no significant difference is the number of opioid prescriptions given after introduction of the required PDMP query, but there was an 18% decrease in the median number of 5mg oxycodone equivalents prescribed before and after the PDMP query (P < .001). This was consistent in both an opioid naive and opioid exposed population. CONCLUSION: This is the first study to establish that required PDMP queries may reduce the number of discharge opioid pills prescribed in a surgical setting. Required PDMP queries may help reduce the harm associated with opioid overprescribing.
OBJECTIVE: To examine the effectiveness of the introduction of the Pennsylvania Prescription Drug Monitoring Program (PDMP) on discharge postoperative opioid prescriptions in patients undergoing major urologic procedures within a large single tertiary care hospital. Opioids have historically been prescribed to control postoperative pain, but with growing concern regarding opioid overdose, misuse, and diversion, measures have been introduced to curb opioid prescribing. Numerous states have introduced PDMP programs as a method to search patients' prior opioid prescriptions. These programs have reduced opioid prescriptions in emergency department and outpatient settings, but their effectiveness, and the use of a prescriber query mandate, in reducing postoperative opioid prescribing has not been established. METHODS: We identified 582 patients who underwent major prostate or renal surgery between July 1st 2016 and June 30th 2017 at a single large academic hospital. We examined prescribing trends in both opioid naive and opioid tolerant patients measuring 5mg oxycodone equivalents before and after a PDMP query was mandated on January 1st 2017. RESULTS: There was no significant difference is the number of opioid prescriptions given after introduction of the required PDMP query, but there was an 18% decrease in the median number of 5mg oxycodone equivalents prescribed before and after the PDMP query (P < .001). This was consistent in both an opioid naive and opioid exposed population. CONCLUSION: This is the first study to establish that required PDMP queries may reduce the number of discharge opioid pills prescribed in a surgical setting. Required PDMP queries may help reduce the harm associated with opioid overprescribing.
Authors: Scott R Hawken; Spencer C Hiller; Stephanie Daignault-Newton; Khurshid R Ghani; John M Hollingsworth; Bronson Conrado; Conrad Maitland; David L Wenzler; John K Ludlow; Sapan N Ambani; Chad M Brummett; Casey A Dauw Journal: Urology Date: 2021-09-01 Impact factor: 2.649