Effect of Opioid Prescribing Education for Ob/Gyn Residents in a Safety-Net Hospital [3I

Abstract

INTRODUCTION: The U.S. opioid epidemic calls for urgent need to evaluate providers’ prescribing habits. The purpose of this study was to educate Ob/Gyn residents regarding opioid abuse, amounts typically used post-operatively, and strategies to decrease adverse outcomes. Our hypothesis is residents will prescribe fewer opiate doses for patients’ post-operative pain management following provider education. METHODS: Ob/Gyn residents at UF Health Jacksonville were given a pre-intervention survey to gauge opioid prescribing patterns and utilization of resources like Prescription Monitoring Programs (PMP) and Opioid Risk Tool (ORT). Residents then attended a didactic session reviewing rates of adverse outcomes from overprescribing, resources to reduce adverse outcomes, and amount of opioids considered appropriate post-operatively. Residents completed a post-intervention survey to re-evaluate prescribing patterns. RESULTS: 13 residents completed both pre- and post-surveys. For cesarean delivery, 100% of residents prescribed at least 30 pills prior to education, but none prescribed more than 20 pills after intervention (p=<0.0001). Similar but less distinct shifts can be seen in laparoscopic hysterectomy (TLH) and use of pre-operative gabinoids. 54% prescribed 20 pills or more following TLH initially while only 7.7% prescribed more than 20 pills after education (p=0.0382). Pre-operative gabinoid usage consideration increased from 15.4% to 100% following intervention. CONCLUSION: Focused opioid education can greatly reduce the amount of opioids prescribed in a post-operative setting. This study highlights the impact educational curriculums can have on prescribing patterns by allowing providers to better understand the current epidemic as well as how to optimize stepwise multimodal analgesia to avoid over-prescribing opioids.