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Effect of Targeted Education on Opioid-Prescribing outcomes: A Quality Improvement Review
Stephenie Poris, M.D. ; Gary Pennington, M.D.
Summa health
2019-02-07
Presenter: Stephenie Poris, M.D.
Affidavit:
The resident listed on this project has performed the majority of work.
Director Name: Douglas Wagner, M.D.
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
The misuse of synthetic opioids has become an epidemic in the United States. In 2017, greater than 29,000 deaths occurred due to synthetic opioids other than methadone. While guidelines exist for patients with chronic pain, the CDC has yet to produce guidelines for the surgical population. Perioperative initiatives to decrease the propagation of the opioid crises within the plastic surgery specialties also fall short. Different surgical specialties have written their own guidelines, but there is still minimal evidence based initiatives within the literature.
In 2016, crystal clinic surgeons started an institutional-wide initiative to educate surgeons on opioid-prescribing guidelines that addressed peri-operative opioid use and abuse. With the development and implementation of the Ohio Automated Rx Reporting System (OARRS) to help address prescription drug diversion and abuse, this institutional initiative fell in line with Ohio's health policy.
Our preliminary results indicate that since 2015, the total number of opioid prescriptions have decreased amongst the 44 surgeons reviewed. Between 2015-2016, 2016-2017, and 2017-2018, prescriptions fell by 7% (1803), 11% (2520), and 4% (916) respectively year-over-year. Furthermore, total number of pills prescribed also decreased by 18% (243422), 26% (289791), and 20% (164469), year-over-year.
Our quality improvement study reviewed the Crystal clinic's experience with developing and implementing prescriber education on post-operative opioid use after inpatient and ambulatory surgery. We believed that this education would decrease opioid prescribing outcomes. Our preliminary review of the data shows a correlation with our educational initiatives and number of opioids prescribed.
