An audit of the quantity of immediate release oxycodone 5 mg tablets prescribed for discharge: an area for improved opioid stewardship?

Abstract

AbstractBackgroundThe Pharmaceutical Benefits Advisory Committee (PBAC) recommended reduced pack sizes of oxycodone 5 mg immediate release (IR) tablets from 20 tablets per box to 10 in 2019. Queensland Health hospitals adopted this recommendation before full implementation of the PBAC requirement and restricted discharge and outpatient quantities to a maximum of 10 tablets. Examining prescribing trends in line with the altered PBAC prescribing quantities is an important component of Opioid Stewardship programs.AimTo review the current state of oxycodone 5 mg IR tablet quantity prescribing on discharge prior to the pack size changes.MethodA retrospective audit on a randomised cohort of every fifth patient discharged with a prescription for oxycodone 5 mg IR tablets was undertaken at a tertiary metropolitan hospital during July 2019. Quantity supplied was reviewed based on age, indication, length of stay and opioid taking status prior to admission.Results141 patients were audited, representing 19% of the eligible 730 patients. Patients were prescribed a mean quantity of 13.1 oxycodone 5 mg IR tablets. The lowest quantity prescribed was three tablets, and the largest was 20 tablets. 71 (50%) patients received 10 tablets on discharge, and 51 (26%) received 20 tablets. No statistically significant difference in the quantity of tablets prescribed was found between the patient sub‐categories examined.ConclusionFurther improvement to individualise opioid quantities on discharge is required. Consideration should be given to widen the scope of repeat audits to include a more patient‐centred approach to opioid prescribing follow up survey.