Post-Operative Prescription of Opioid Medications and Patient Education: A Pilot Study

Abstract

Introduction: Opioid medications are essential in the management of pain. 80-85% of surgical patients and 51% of inpatients are discharged with opioid prescriptions. With increased prescriptions, an increase in opioid abuse and overdose was identified. In 2018, nearly 47,000 deaths were reported secondary to opioids. Also, in 2015, 504 billion dollars were spent on the opioid crisis. Our aim was to determine if our division, urology, was prescribing opioids appropriately in the post-operative setting. We sought to identify gaps in patient knowledge of opioid risks, storage, and disposal. Methods: Our institution initiated an after-visit summary (AVS) detailing opioid abuse, storage, and disposal. This AVS was given to all patients that were discharged, inpatient and outpatient, with an opioid prescription. Our group analyzed patient use of opioids and knowledge before and after AVS initiation in 2019-2020. This was done using surveys at initial follow up of post-operative patients. Only completed surveys were analyzed, 50 pre-protocol and 44 post-protocol. Results: While no statistically significance difference was noted for patient knowledge, we observed a clinical difference in usage of entire opioid prescription, 20% pre-protocol vs 11% post-protocol. More patients disposed of narcotics, 60% pre-protocol vs 91% post-protocol. Pre-protocol, zero patients identified addiction as a risk of opioid use while four post-protocol. Additionally, areas of improvement were identified within the AVS. Conclusion: The survey was not statistical significance, it suggested clinical differences. Opioid prescribing is important in medicine but requires continued learning of best practices and understanding of opioid risks.