Publication date: Jan 02, 2019
Our institution developed a 1-hour mandatory narcotics-prescribing education program as well as postoperative opioid-prescribing guidelines in response to the opioid epidemic. The purpose of this study was to evaluate the effect of this hospital-wide opioid education and subsequent institution of postoperative opioid guidelines on opioid-prescribing practices after ambulatory surgery.
This retrospective study was performed at 1 academic orthopaedic hospital. In November 2016, a 1-hour mandatory opioid education program was completed by all hospital prescribers. Postoperative opioid guidelines were then developed and were disseminated in February 2017. All postoperative narcotic prescriptions after ambulatory procedures performed by 3 separate services (hand, sports, and foot and ankle services) were evaluated over 4 months prior to and after the mandatory opioid education and subsequent release of service-specific guidelines.
Overall, there was a significant decrease in pills and total oral morphine equivalents prescribed after dissemination of guidelines compared with the pre-intervention cohort procedures (p 0.05) in either the number of pills or the oral morphine equivalents prescribed after any of the 3 procedures performed by the foot and ankle service (ankle arthroscopy, bunion surgery, and Achilles tendon repair).
We developed a prescriber education program and followed up with consensus-based guidelines for postoperative opioid prescriptions. These interventions caused a significant decrease in excessive opioid-prescribing practices after ambulatory orthopaedic surgery at our hospital. We urge initiatives by national orthopaedic organizations to develop and promote education programs and procedure and disease-specific opioid-prescribing guidelines.
Stepan, J.G., Lovecchio, F.C., Premkumar, A., Kahlenberg, C.A., Albert, T.J., Baurley, J.W., and Nwachukwu, B.U. Development of an Institutional Opioid Prescriber Education Program and Opioid-Prescribing Guidelines: Impact on Prescribing Practices. 03207. 2019 J Bone Joint Surg Am (101):1.
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