March 18, 2019

Effect of hospital intervention, state legislation on postop opioid prescribing practices

By: Judy Mathias
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Editor’s Note

After a hospital-wide intervention and state-wide legislation, this community hospital in Michigan achieved a 60%-70% decrease in postoperative opioid prescriptions and less variation in opioid prescription practices.

This retrospective study of opioid naïve adult patients who had one of five general surgical procedures between 2015 and 2017 found the average oral morphine equivalent (OME) prescribed before the interventions varied significantly:

  • 235.3 for cholecystectomy
  • 220.2 for appendectomy
  • 214.4 for open inguinal hernia repair
  • 187.7 for minimally invasive inguinal hernia repair
  • 212.5 for lumpectomy.

A review of cases after the interventions found a significant reduction in the OME prescribed each year (mean OME 197.6 before vs 72.3 after), and a 60%-70% reduction in average OME per procedure.

The data also showed less variation in prescription practices and a significant increase in patients prescribed multimodal pain therapy (23.5% vs 31.5%).

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