Literature DB >> 33620897

A Randomized Controlled Trial Assessing the Impact of Opioid-Specific Patient Counseling on Opioid Consumption and Disposal After Reconstructive Pelvic Surgery.

Kristen Buono1, Emily Whitcomb2, Noelani Guaderrama2, Elizabeth Lee1, Jun Ihara2, Neha Sudol, Felicia Lane1, Jennifer Lee2, Bhumy Davé Heliker1, Taylor Brueseke1.   

Abstract

OBJECTIVES: This study aims to determine the effect of opioid-specific counseling on postdischarge opioid consumption and opioid storage/disposal patterns after reconstructive pelvic surgery.
METHODS: In this multicenter randomized-controlled trial, participants were randomized to standard generalized counseling or opioid-specific perioperative counseling. Opioid-specific counseling was provided at the preoperative and 2-week postoperative visits with educational handouts about the risks of opioids and U.S. Food and Drug Administration recommendations for appropriate opioid storage and disposal. The primary outcome was morphine milligram equivalent (MME) consumption between hospital discharge and 2 weeks postoperatively. Secondary outcomes included opioid storage 2 weeks postoperatively, opioid disposal 6 weeks postoperatively, and rate of opioid refills.
RESULTS: Among 70 opioid-specific and 65 standard counseling participants, there were no significant differences in demographic characteristics, type of surgery, concomitant hysterectomy, or perioperative complications. For the primary outcome, there was no significant difference in median opioid consumption between the 2 arms. Median (interquartile range) postdischarge MME consumption for all participants was 15 mg (0-75). Forty percent of participants denied postdischarge MME consumption. For secondary outcomes, there were no significant differences in appropriate opioid storage between groups. The appropriate disposal rate of unused opioid tablets 6 weeks after surgery was higher among participants who received opioid-specific counseling. The rate of opioid refill was 7.4%.
CONCLUSIONS: Opioid-specific counseling did not affect postdischarge consumption but increased the disposal rate of unused opioid tablets 6 weeks postoperatively. Opioid-specific counseling could minimize the potential for opioid misuse by reducing the number of unused opioid tablets in patients' possession after surgery.
Copyright © 2021 American Urogynecologic Society. All rights reserved.

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Year:  2021        PMID: 33620897     DOI: 10.1097/SPV.0000000000001009

Source DB:  PubMed          Journal:  Female Pelvic Med Reconstr Surg        ISSN: 2151-8378            Impact factor:   2.091


  2 in total

1.  The NOpioid Project: a prospective observational feasibility study examining the implementation of a non-narcotic post-operative pain control regimen.

Authors:  Joseph DeVitis; Emily Flom; Tristan Cooper-Roth; Alan Davis; Laura Krech; Chelsea Fisk; Steffen Pounders; Douglas Kwazneski; Alistair Chapman; Carrie Valdez
Journal:  Surg Endosc       Date:  2022-03-04       Impact factor: 4.584

2.  Risk Factors for Postoperative Narcotic Use in Benign, Minimally-Invasive Gynecologic Surgery.

Authors:  Anja S Frost; Jaden Kohn; Karen Wang; Khara Simpson; Kristin E Patzkowsky; Harold Wu
Journal:  JSLS       Date:  2022 Jul-Sep       Impact factor: 1.789

  2 in total

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