Postoperative Opioid Rx Size Down After Guideline Release

A reduction in postoperative opioid prescription size was observed following release of evidence-based opioid prescribing guidelines in Michigan, according to a research letter published in the issue of the New England Journal of Medicine.

Joceline V. Vu, M.D., from the University of Michigan in Ann Arbor, and colleagues used data from the Michigan Surgical Quality Collaborative to compare postoperative opioid prescribing before and after release of opioid prescribing guidelines, which were communicated to clinicians in October 2017. Prescription data were included from 11,716 patients across 43 hospitals, obtained from February 2017 through May 2018.

The researchers found that the change in prescription size over time was −0.5 pills per month before the guideline release compared with −1.3 pills per month during the period after the guideline release, representing a significant difference in slope of −0.8 pills per month. There was a decrease in the mean prescription size from 26 ± 2 pills in the preguideline period to 18 ± 3 pills after guideline release. There was also a decrease in opioid consumption from 12 ± 1 pills to 9 ± 2 pills. There were no clinically important changes in satisfaction or pain scores despite the reductions in prescription size and opioid use.

"In our study we found that evidence-based prescribing guidelines reduced postoperative opioid prescription size across a statewide population without negatively affecting patient satisfaction or pain," the authors write.

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