August 17, 2018

Effective interventions for postop opioid prescribing

By: Judy Mathias

Editor's Note

Interventions at the physician or organizational level (eg, workflow changes) were found to be better tools for creating change in postoperative opioid prescribing than interventions at the patient level (eg, patient education), in this review.

This analysis of eight studies published after 2000 that included 2,272 patients found several effective interventions for postoperative opioid prescribing, including:

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  • changes to the electronic healthcare record order set
  • shared decision making
  • multimodal dissemination of guidelines.

In general, physician and organizational level interventions that focused on reducing discharge opioid prescribing were effective. Most studies encouraged use of acetaminophen and nonsteroidal anti-inflammatory drugs as a first-line treatment.

Several studies measured emergency department visits and refill requests to monitor for consequences of reduced prescribing, but no statistically significant differences were reported.

Given the findings, future studies should consider measures of adequate pain management that are more granular than emergency department visits and refill requests, the authors say.


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