Decreasing Postoperative Opioid Prescribing through Education

OBJECTIVES: To study how an educational intervention given to surgical residents affected postoperative opioid prescribing. To determine whether decreased opioid prescription amounts increased patients' rate of refills, emergency department visits, or readmissions. DESIGN: Prospective sequential cohort study. SETTING: Level 1 tertiary care center in Savannah, Georgia. PARTICIPANTS: Opioid-naive patients who underwent general surgery (appendectomy, cholecystectomy, colectomy, hernia repair, lumpectomy, and mastectomy) between November 2017 and February 2018. RESULTS: Over a 6 month period, morphine milligram equivalents (MME) prescribed after general surgery per patient was decreased by 21.8% on average, with the largest reductions seen after breast and gallbladder surgeries (38% and 25% respectively). Patients who underwent laparoscopic surgery were prescribed 18.3% fewer MME. There was no significant change in MME prescribed after open abdominal surgery. Smaller prescription amounts were not associated with an increased rate of opioid refills. There was no increase in pain-related calls to clinic offices, emergency department visits, or readmissions for pain. CONCLUSION: After a single education intervention given to surgical residents, MME prescribed after common general surgeries can be decreased significantly without increasing rates of refills or utilization of care. (C) 2019 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.