MP83-12 EFFECTS OF A REDUCED OPIATE PRESCRIPTION PROTOCOL ON POST-DISCHARGE PILL CONSUMPTION

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety IV (MP83)1 Apr 2020MP83-12 EFFECTS OF A REDUCED OPIATE PRESCRIPTION PROTOCOL ON POST-DISCHARGE PILL CONSUMPTION Kristian Stensland*, Peter Chang, Aaron Berkenwald, Adrian Waisman Malaret, Kortney Robinson, Gabriel Brat, Sarah Hyde, Kyle McAnally, Catrina Crociani, Brian Holliday, Analeesa Baraka, Jodi Mechaber, Marc Manganiello, David Canes, Alireza Moinzadeh, and Andrew Wagner Kristian Stensland*Kristian Stensland* More articles by this author , Peter ChangPeter Chang More articles by this author , Aaron BerkenwaldAaron Berkenwald More articles by this author , Adrian Waisman MalaretAdrian Waisman Malaret More articles by this author , Kortney RobinsonKortney Robinson More articles by this author , Gabriel BratGabriel Brat More articles by this author , Sarah HydeSarah Hyde More articles by this author , Kyle McAnallyKyle McAnally More articles by this author , Catrina CrocianiCatrina Crociani More articles by this author , Brian HollidayBrian Holliday More articles by this author , Analeesa BarakaAnaleesa Baraka More articles by this author , Jodi MechaberJodi Mechaber More articles by this author , Marc ManganielloMarc Manganiello More articles by this author , David CanesDavid Canes More articles by this author , Alireza MoinzadehAlireza Moinzadeh More articles by this author , and Andrew WagnerAndrew Wagner More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000975.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prescribing fewer opiates may lead to less narcotic use and fewer excess pills in the community. We employed a multiphase opiate reduction protocol to assess baseline use, change prescribing protocols, and assess the impact of the change. METHODS: Patients prospectively recorded home pain pill use in a written log after robotic radical prostatectomy (RALP) and robotic partial nephrectomy (RPN) at 2 institutions from 7/2016 to 7/2019. Log accuracy was validated by independent phone contact in a subset of patients. We extracted in-hospital narcotic use, POD1 visual analog scale (VAS) pain scores, and patient comorbidities from our EMRs. In 7/2018, we instituted new prescribing guidelines to meet an estimated 80% of patients’ opiate requirements. RESULTS: Phone survey pill counts exactly matched written logs in 69% of patients and varied by only 1-2 pills in 93% of patients. Of the 193 RALP patients, 137 (71%) were in the pre-intervention group (20-30 pills), and 56 (29%) were in the post-intervention group (5 pills). In the pre-intervention RALP group, 64/137 (47%) patients took no opiates post-discharge, and 90/137 (66%) took <= 2 pills. In the post intervention group, 23/56 (41%) took no opiates post-discharge, and 37/56 (66%) took <= 2 pills. Of the 73 RPN patients, 56 (77%) were in the pre-intervention (20-30 pills), and 17 patients (23%) were in the post-intervention group (15 pills). In the pre-intervention PN, group, 17/56 (30%) patients took no opiates post-discharge. In the post-intervention PN group (15 pills), 3/17 (18%) of patients took no opiate pills post-discharge. After intervention, our new guidelines reduced the number of pills prescribed by 1,655 pills for these 73 patients, compared to what would have been prescribed in prior protocols. 0 and 2 additional prescriptions were filled in the pre- and post-intervention groups, respectively. CONCLUSIONS: Reducing quantity of opiates prescribed tailored by validated institutional data allowed for decreased excess pills with minimal impact on absolute number of pills taken and the number of additional requested prescriptions. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1260-e1260 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kristian Stensland* More articles by this author Peter Chang More articles by this author Aaron Berkenwald More articles by this author Adrian Waisman Malaret More articles by this author Kortney Robinson More articles by this author Gabriel Brat More articles by this author Sarah Hyde More articles by this author Kyle McAnally More articles by this author Catrina Crociani More articles by this author Brian Holliday More articles by this author Analeesa Baraka More articles by this author Jodi Mechaber More articles by this author Marc Manganiello More articles by this author David Canes More articles by this author Alireza Moinzadeh More articles by this author Andrew Wagner More articles by this author Expand All Advertisement PDF downloadLoading ...