Results of a Prospective, Multicenter Initiative Aimed at Developing Opioid-prescribing Guidelines After Surgery

Annals of Surgery
Cornelius A ThielsElizabeth B Habermann

Abstract

The aim of this study was to conduct a prospective, multicenter survey of patients regarding postoperative opioid use to inform development of standardized, evidence-based, procedure-specific opioid prescribing guidelines. Previous work has shown significant variation in the amount of opioids prescribed after elective procedures, calling for optimization of prescribing. Adults (n = 3412) undergoing 25 elective procedures were identified prospectively from 3 academic centers (March 2017 to January 2018) to complete a 29-question telephone interview survey 21 to 35 days post-discharge (n = 688 not contacted, n = 107 refused). Discharge opioids were converted into Morphine Milligram Equivalents (MMEs). Of the 2486 patients who completed the survey, 91.2% received opioids at discharge [median 225 (interquartile range, IQR 125 to 381) MME]. A median of 43 (0 to 184) MMEs were consumed after discharge with 77.3% of patients having leftover opioids at the time of the survey. In total, 61.5% of prescribed opioids were unused; 31.4% of patients used no opioids, and 52.6% required <50 MME. Overall, 90.6% of patients were satisfied with their postdischarge pain control. While 28.3% reported being prescribed too many opioids, 9.0% felt the...Continue Reading

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Citations

Mar 23, 2019·Advanced Healthcare Materials·Xiong GaoYu Chen
Jun 22, 2019·The Laryngoscope·Sophia DangDavid Cognetti
Jul 13, 2019·Journal of Surgical Oncology·Brittany L MurphyElizabeth B Habermann
Aug 15, 2019·JAMA Surgery·Brooke A ChidgeyPeggy P McNaull
Sep 4, 2019·Annals of Surgery·Ryan HowardJennifer Waljee
Apr 7, 2020·The Journal of Bone and Joint Surgery. American Volume·Lia D DelaneyJennifer F Waljee
Jul 17, 2020·American Journal of Public Health·Jean Y LiuJoseph C Anderson
Aug 12, 2020·The American Surgeon·Jessica L MillardJeremy A Warren
Sep 30, 2020·Anesthesiology·Harsha ShanthannaGirish P Joshi
Mar 7, 2020·Frontiers in Surgery·Cade ShadboltPeter F M Choong
Oct 3, 2020·JBJS Reviews·Ophelie Lavoie-GagneBrian Forsythe
May 16, 2019·BMJ : British Medical Journal·Cornelius A ThielsMolly M Jeffery
Jan 25, 2020·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Johnna JaynsteinJoshua A Parry
Mar 17, 2019·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Gregg NelsonSean C Dowdy
Jul 28, 2019·Obstetrics and Gynecology·Sean C DowdyMichael Scott
Mar 25, 2019·Obesity Surgery·Danielle T FriedmanAndrew J Duffy
Aug 2, 2020·Mayo Clinic Proceedings·Nafisseh S WarnerElizabeth B Habermann
Jan 14, 2021·The Breast Journal·Halley DarrachJustin M Sacks
Jan 24, 2021·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Javier LasalaPedro T Ramirez
Jul 31, 2020·The Journal of Surgical Research·Alexa K PiusCharles D MacLean
Jul 28, 2020·The Journal of Surgical Research·Stephanie Y KwanCarolyn D Seib
Aug 8, 2019·Annals of Surgery·Daniel B LarachChad M Brummett
Sep 15, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Cody C WylesElizabeth B Habermann
Mar 13, 2021·Current Opinion in Ophthalmology·Matthew R StarrYoshihiro Yonekawa
Mar 31, 2021·American Journal of Surgery·Jackly M JuprasertHeather L Yeo
Apr 4, 2021·Healthcare·Sara J HylandRobert K Cleary
Nov 2, 2019·The Journal of Surgical Research·Liese C C PruittDavid E Skarda
Jun 24, 2019·Surgery·Ariel W KnightCornelius A Thiels
Apr 7, 2021·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Samantha AnneTaskin M Monjur
Nov 8, 2020·Annals of Vascular Surgery·Mariah B BlegenMichael C Stoner
Apr 21, 2021·American Journal of Otolaryngology·Tara E MokhtariMark A Varvares

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