Wednesday, 8 August 2018

Study shows reduced opioid prescriptions after surgery

Overprescribed opioids is a common occurrence after surgery, resulting in leftover pills that could fall into the wrong hands, according to researchers. The study looked at reviews of 1,158 patient charts — 558 of which shows operations that occurred before the opioid recommendations were in effect, with 600 surgeries taking place more than 10 months after the new guidelines.

Researchers found that for sleeve gastrectomy, the most extensive procedure, the average prescription post-surgery was 89 pills before the recommendations and 58 afterward. The number of pills prescribed for hernia repair went from 37 pills to 21 — a 43% reduction and 35 pills to 17 after an appendectomy — about a 50% reduction, according to the study.
Thyroidectomy/parathyroidectomy post-surgery prescriptions went from 16 pills to eight.

Seniors support opioid prescription limits:

A recent AARP and University of Michigan survey found a majority of older adult’s support limits on opioid prescriptions. Three in four seniors support limits on the total number of days and pills that can be prescribed, according to the poll. Fewer than half of senior’s support guidelines requiring the return of unused medications.

Following the original recommendations for prescribing opioids post-gall bladder removal, the Michigan Surgical Quality Collaborative and Opioid Prescribing Engagement Network developed recommendations for 17 other procedures, including three types of hysterectomy, breast biopsy and mastectomy.

This study details how surgeons at the University of Michigan discovered a “spillover” effect after the development of prescribing recommendations based on published medical evidence for gall bladder removal. As a result, the surgeons began prescribing about 10,000 fewer pills for major operations, according to the study published in an article in the Journal of the American College of Surgeons.

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