You have accessJournal of UrologyCME1 Apr 2023PD28-05 QUALITY IMPROVEMENT ON POST URETEROSCOPY OPIOID PRESCRIBING PRACTICES Mark Hasell, Zachary A. Valley, Francisco Aguirre, Jennifer Bolt, Andrew Graham, and Kamaljot S. Kaler Mark HasellMark Hasell More articles by this author , Zachary A. ValleyZachary A. Valley More articles by this author , Francisco AguirreFrancisco Aguirre More articles by this author , Jennifer BoltJennifer Bolt More articles by this author , Andrew GrahamAndrew Graham More articles by this author , and Kamaljot S. KalerKamaljot S. Kaler More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003313.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Due to the public health crisis of opioid misuse in North America, several recent studies have examined the use of minimal or opioid free prescriptions following various surgeries in opioid naïve patients (ONPs). In May 2021, we started a quality improvement project for elective and emergency ureteroscopy (URS) for nephrolithiasis with opioid free standardized prescriptions consisting only of Ketorolac, Acetaminophen, Solifenacin, Ciprofloxacin, and Tamsulosin to be used by the adult Urology group at their discretion. METHODS: The control cohort consisted of ONPs who underwent URS in the 12 months prior to initiation of intervention while the opioid free cohort consisted of ONPs who underwent URS in the 12 months after initiation of intervention. Our main outcome was the average morphine milligram equivalents (MME) of prescriptions filled for pain control within 3 days of hospital discharge. Our balancing measures included readmission within 90 days and outpatient MME prescriptions filled between 3- and 90-days post discharge. Measures were compared across pre- and post-intervention groups using control charts and traditional hypothesis testing. RESULTS: In the current study, 3256 patients were retrospectively reviewed; the opioid free cohort consisted of 1373 ONPs and the control cohort consisted of 1883 ONPs. The average age was 53 with 60% males. Majority of stones were >4mm and majority of patients had multiple stones. There was a significant reduction in MME prescriptions filled in the opioid free cohort compared to the control (19.7 vs. 41.2, p<0.001) (Figure 1). System stability was maintained post intervention along with no significant increase in readmission rates in the experimental cohort (Figure 2). CONCLUSIONS: Using a simple standardized prescription intervention following URS in large series of over 3000 patients, there was a significant reduction of 50% in opioids prescribed at discharge with no significant increase in outpatient prescriptions or readmissions. This intervention provides evidence for opioid free discharges in ONPs undergoing URS. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e820 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mark Hasell More articles by this author Zachary A. Valley More articles by this author Francisco Aguirre More articles by this author Jennifer Bolt More articles by this author Andrew Graham More articles by this author Kamaljot S. Kaler More articles by this author Expand All Advertisement PDF downloadLoading ...