Individualized Opioid Interventions Can Reduce Use After Surgery

Guidance published in the Journal of the American College of Surgeons can help physicians effectively address a patient’s pain with reduced opioid usage after surgery. The recommendations, titled Guidelines for Patient-Centered Opioid Prescribing and Optimal FDA-Compliant Disposal of Excess Pills after Inpatient Operation: Prospective Clinical Trial, conclude that personalized opioid intervention before discharge from the hospital can cut overall opioid intake, while still ensuring a patient is satisfied with their pain management.

According to Patient Engagement HIT, the study, which involved 229 patients who remained hospitalized for at least 48 hours after an operation, utilized a post-surgical prescribing guideline to evaluate study participants’ opioid intake the day before discharge. At the time of discharge, physicians used the study’s benchmark opioid-sparing protocol to issue prescriptions. These included both the non-opioid analgesics acetaminophen and ibuprofen, as well as the predetermined amount of opioids. Additionally, the recovering surgical patients were provided with clear instructions to take the non-opioid medications as part of their pain management regime.  

Despite the reduced amount of prescribed opioids, study participants reported high levels of satisfaction with their care plan, particularly those who took no opioids prior to leaving the healthcare facility. Lead study author Richard Barth Jr., of Dartmouth-Hitchcock, says surgeons can curtail opioid use by setting clear expectations related to pain. He explains it is essential to inform patients that some degree of pain and discomfort is acceptable after a procedure.

Furthermore, says Barth, patient education should include instruction on properly disposing of excess medication. The research team found that interventions, such as office reminders about disposal and pill drop boxes, led to patient compliance with the Food and Drug Administration’s protocol on opioid disposal.

As part of MLMIC’s ongoing efforts to provide information to our policyholders on strategies that address opioid use, we offer a number of resources, including Risk Management Tips that can be beneficial in formulating a plan and documenting the care and treatment of these complex patients:

• Risk Management Tip #10: Managing Patients with Chronic Pain
• Risk Management Tip #14: Managing Drug Seeking Patients