Post-Operative Order Set Decreases Opioid Prescriptions and Increases Efficiency

Author:

Bates Jenna N.1ORCID,Batra Anjay K.1,Auerbach Jeremy M.1,Pathak Ujval I.1,Hoang Nhi2,Taylor Jennifer M.12

Affiliation:

1. Department of Urology, Baylor College of Medicine, Houston, TX, USA

2. Michael E. DeBakey VA Medical Center, Houston, TX, USA

Abstract

Background Opioid addiction remains a public health crisis. We aimed to create an electronic medical record (EMR) based protocol to decrease post-operative prescribing of opioid medications and streamline the ordering process while maintaining adequate pain control. Methods An order set was created to minimize opioid prescriptions. The post-operative prescribing practices for minor urologic procedures (MUOs) over 6-week periods at three time points were compared: one period before and two periods after implementation of the order set. Results 72 MUOs were performed in the pre-implementation, 52 in post-implementation, and 60 in the long-term period. Opioid medications were prescribed for 66 patients (91.7%) pre-implementation, 23 patients (44.2%) post-implementation, and 45 patients (75.0%) at the long-term time point ( P < .0001 and P = .015 respectively). The mean morphine milligram equivalent (MME) prescribed was 81.52 units before implementation, 38.74 units after, and 24.21 units at the long-term time point ( P = .0002 and P < .0001 respectively). Discussion The integration of a post-operative prescribing order set into our EMR substantially decreased opioid prescribing after MUO while streamlining the ordering process to improve efficiency.

Publisher

SAGE Publications

Subject

General Medicine

Reference24 articles.

1. Trends in Medical Use and Abuse of Opioid Analgesics

2. U.S. Opioid dispensing rate maps | Drug overdose. Atlanta, GA: CDC Injury Center. https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html. Accessed 6 June 2021.

3. Overdose death rates. Baltimore, MD: National Institute on Drug Abuse (NIDA). https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates. Accessed 6 June 2021.

4. New strategies for post-operative pain management. https://grandroundsinurology.com/new-strategies-for-post-operative-pain-management/. Accessed 6 June 2021.

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