Patient pain satisfaction scores unaffected by opioid reduction protocol utilizing morphine equivalent dose calculations

Abstract

Listen

Translate article

Opioids are important for pain management during inpatient rehabilitation facility (IRF) stays, but are potentially overprescribed. Previously, we performed a prospective study utilizing an opioid reduction protocol to significantly reduce the opioid burden in patients admitted to an IRF. This study retrospectively analyzed patient pain satisfaction survey scores to determine the effect of the opioid reduction protocol on patient pain satisfaction. We included all patients admitted to an IRF at an academic institution during a two-month period in 2016 and calculated the Morphine Equivalent Dose (MED) for admission and discharge. We delivered informative lectures to prescribers regarding CDC recommendations, posted MED charts, calculated weekly MED scores and repeated MED calculations for all admissions and discharges over the following two months. Satisfaction surveys were sent to all patients upon discharge, with pain scored 0 to 5 (0-not controlled, 5-extremely well controlled). Surveys were obtained from 34 of 75 patients in the pre-intervention group and 41 of 87 in the post-intervention group. There was no statistical difference in pain satisfaction between the two groups ( P = 0.38) with an average satisfaction of 3.68 and 3.32 for the pre and post-interventional groups, respectively. MED was decreased from admission to discharge in the pre-intervention group by an average of 17.79, a 44% decrease, while the post-interventional group MED decreased on average by 24.08, a 49% decrease. These findings are an important, since the primary study showed dramatic reductions in MED between pre and post intervention groups, reducing the percent of patients whose MED was greater than 50 by nearly half (23% to 12%). This study demonstrates a method of tracking patient pain satisfaction whilst reducing opioid utilization in an IRF setting, and provides evidence that opioid weaning by tracking MED calculations does not negatively influence patient pain control satisfaction.