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A retrospective study comparing postoperative opioid prescribing practices in an academic medical centre.
- Source :
- Canadian Pharmacists Journal; Sep2022, Vol. 155 Issue 5, p277-284, 8p
- Publication Year :
- 2022
-
Abstract
- Background: In the midst of the North American opioid crisis, identifying and intervening on drivers of high-risk opioid prescriptions is an important step towards reducing iatrogenic harm. Objectives: We aimed to identify factors associated with variations in high-risk opioid discharge prescriptions, following select surgical procedures, to guide future quality improvement initiatives. Methods: This retrospective cohort study analyzed 1322 patients who underwent select open pelvic and open abdominal surgeries between January 1 and December 31, 2017, in a tertiary health care centre in Montreal. Results: Patients who underwent open abdominal surgeries were prescribed significantly higher daily doses of morphine milligram equivalents (MME) (45 mg; interquartile range, 30-60), than patients who underwent either a caesarean delivery (20 mg, 20-20) or a hysterectomy (30 mg, 22-30). After adjustment for multiple potential confounders, abdominal surgery was associated with 4 times the odds of receiving more than 50 MME at hospital discharge compared with pelvic surgeries (odds ratio, 3.96; 95% confidence interval, 1.31-11.97). The availability of postoperative preprinted order sets with fixed high doses of opioids was also highly associated with the outcome. Conclusion: In our institution, some surgeries were more likely to receive high-risk opioid prescriptions at discharge. Efforts to optimize safer prescribing practices should address the creation and/or updating of preprinted order sets to reflect current best practice guidelines. This initiative could be overseen by hospital pharmacy and therapeutics committees. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 17151635
- Volume :
- 155
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Canadian Pharmacists Journal
- Publication Type :
- Academic Journal
- Accession number :
- 158866145
- Full Text :
- https://doi.org/10.1177/17151635221110153