PD09-09 EVALUATION OF POSTOPERATIVE OPIOID PRESCRIBING FOLLOWING COMMON UROLOGIC PROCEDURES IN THE STATE OF WISCONSIN

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety II (PD09)1 Apr 2020PD09-09 EVALUATION OF POSTOPERATIVE OPIOID PRESCRIBING FOLLOWING COMMON UROLOGIC PROCEDURES IN THE STATE OF WISCONSIN Aravind Viswanathan*, Caprice Greenberg, Jessica Schumacher, Manasa Venkatesh, Jonathan Kohler, Elise Lawson, Kyle Richards, Edwin Abel, Tracy Downs, David Jarrard, and Tudor Borza Aravind Viswanathan*Aravind Viswanathan* More articles by this author , Caprice GreenbergCaprice Greenberg More articles by this author , Jessica SchumacherJessica Schumacher More articles by this author , Manasa VenkateshManasa Venkatesh More articles by this author , Jonathan KohlerJonathan Kohler More articles by this author , Elise LawsonElise Lawson More articles by this author , Kyle RichardsKyle Richards More articles by this author , Edwin AbelEdwin Abel More articles by this author , Tracy DownsTracy Downs More articles by this author , David JarrardDavid Jarrard More articles by this author , and Tudor BorzaTudor Borza More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000836.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Postoperative opioid prescribing is associated with a 6% new persistent use rate in previously opioid naïve patients and accounts for significant supply available for diversion to the illicit market. Increased awareness of the opioid epidemic has let to various efforts to curb overprescribing. To assess the effect of these efforts we evaluated prescribing patterns following common urologic procedures in the state of Wisconsin. METHODS: We used Wisconsin Health Information Organization data, an all-payer claims database covering 75% of Wisconsin’s population to identify patients undergoing common urologic procedures (Major: cystectomy, prostatectomy, nephrectomy and Minor: vasectomy, prostate biopsy, ESWL, ureteroscopy, TURP, TURBT). We limited our analysis to Medicaid and commercial insurance data to ensure complete ascertainment of prescription fills. We measured the opioid dose prescribed within 7 days of discharge and identified surgeon level variation in prescribing following both Major and Minor procedures. RESULTS: We identified 11,139 patients undergoing Minor procedures and 937 patients undergoing Major procedures. Initial fill rates ranged from 3.6% (prostate biopsy) to 70.6% (prostatectomy, Table). Higher initial doses were prescribed following Major surgery with a median range of 200-247 morphine milligram equivalents (MME) compared to Minor surgery, where the median range was 75-146 MME. We noted significant surgeon level variation within Minor and Major procedures (Figure). CONCLUSIONS: Opioid prescribing remains common after the majority of common urologic procedures. Significant surgeon level variation exists within the state of Wisconsin in regards to initial postoperative opioid prescriptions. Understanding drivers of this variation is critical to ongoing efforts attempting to address opioid overprescribing. Source of Funding: Pilot grant from Wisconsin Urologic Society © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e177-e178 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aravind Viswanathan* More articles by this author Caprice Greenberg More articles by this author Jessica Schumacher More articles by this author Manasa Venkatesh More articles by this author Jonathan Kohler More articles by this author Elise Lawson More articles by this author Kyle Richards More articles by this author Edwin Abel More articles by this author Tracy Downs More articles by this author David Jarrard More articles by this author Tudor Borza More articles by this author Expand All Advertisement PDF downloadLoading ...