Opioid Reduction and Elimination in Pediatric Surgical Patients
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Oct 2021 · 1 min read
In brief
In brief
Quality improvement study examining opioid prescribing patterns in pediatric same-day surgery patients found significant overprescribing, with 78-98% of patients having leftover opioids and only 20-25% disposing them properly. Non-opioid pain management strategies increased significantly over the study period, and subset analysis showed inguinal hernia and orchiopexy patients discharged without opioids did not require them postoperatively.
Written by the GCMD Library team from the article.
INTRODUCTION
Opioid overuse is a national concern. Mitigation strategies include judicious prescribing and encouragement of non-opioid therapies. This quality improvement project aimed to identify physician opioid prescribing and patient usage patterns at a pediatric academic center.
METHODS
Patients who underwent same-day general, orthopedic, or plastic surgery procedures were contacted 7 - 28 days post-operatively. Inquiries were made about opioid usage, non-opioid strategies, and overall pain management satisfaction. A subset of general surgery patients not prescribed opioids was compared to those prescribed opioids.
RESULTS
Between August 2017 – May 2020, 558 surveys were obtained. There was a significant increase in the use of non-opioid therapies between 2017 and 2020 (83.5% vs 97%, p=0.04). Almost all patients' opioid prescriptions were filled; however, 78-98% had leftover opioids. Only 20-25% disposed the excess opioids. In subset analysis of general surgery patients, no inguinal hernia or orchiopexy patient who was discharged without opioids required opioids later. More non-opioid patients used other therapies (acetaminophen, heat (p=0.03)); however, pain management satisfaction was higher in the opioid group (99% vs 94%, p=0.01).
CONCLUSION
While our opioid prescribing has decreased, physicians are still prescribing more opioids than patients require. Further education on non-opioid pain therapies and proper disposal of opioids are needed.
LEVEL OF EVIDENCE
III
TYPE OF STUDY
prospective quality improvement study