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Educational intervention, overprescription reduce opioid use after pelvic floor surgery

15 May 2019
The more painful the surgery, the more likely addiction is, according to a report by the research firm QuintilesIMS Institute for Healthcare Informatics

Overprescription of opioids after pelvic floor surgery and a provider education intervention have led to a substantial decrease in opioid prescribing without changing patient satisfaction with pain control, a recent study has found.

In total, 122 patients were prescribed 149 percent more mean morphine mg equivalents than were actually used for sacral neuromodulation, 165 percent more for mid urethral sling and 136 percent more for prolapse repair.

A significant reduction in morphine mg equivalents prescribed for all three surgeries was observed in 78 patients (p<0.001) after the educational intervention. In addition, the following factors were found to be associated with increased opioid use: diabetes (p=0.001), a chronic pain condition (p=0.017) and rectocele repair (p=0.001).

This retrospective review explored prescribing patterns and opioid use in patients who underwent three pelvic floor surgeries (ie, sacral neuromodulation, prolapse repair and mid urethral sling) from June 2016 to May 2017 before and after an educational intervention to reduce opioid prescriptions.

The authors conducted a telephone survey to quantify opioid use after surgery and satisfaction with pain control. They established prescribing recommendations based on these results and performed an educational intervention for clinicians. This was followed by an assessment of changes in opioid prescription and use during the 6 months following the intervention. To identify factors associated with variability in opioid use, a multiple regression model was used.

“The opioid problem has reached epidemic proportions and the prescription of opioids after surgery can lead to chronic use,” the authors said.

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