Patient Education Programs Research Articles

The Malnutrition Universal Screening Tool (MUST) and a nutrition education program for high risk cancer patients: strategies to improve dietary intake in cancer patients

The Malnutrition Universal Screening Tool (MUST) and a nutrition education program for high risk cancer patients: strategies to improve dietary intake in cancer patients

HPB SO25 - The impact of chest physiotherapy on post-operative recovery from open liver surgery: A quality improvement project

Abstract Background The incidence of postoperative pulmonary complications (PPCs) after open liver surgery is high. Risk factors include age, body mass index, ex- or current smoker, and chronic lung disease. Early postoperative chest physiotherapy (CP), an essential part of any enhanced recovery protocol (ERP), can reduce PPCs, length of stay and healthcare costs. This study evaluated the uptake of CP after open liver surgery and resultant outcomes, following a quality improvement (QI) intervention. Method The project design involved two audit cycles: cycle 1 (C1) and cycle 2 (C2), each of five months duration, of consecutive patients undergoing open liver surgery, before and after a QI intervention (intensive preoperative patient education, poster campaign, increased engagement with physiotherapists regarding the importance of timely CP. Patients undergoing laparoscopic resections were excluded. Outcome measures included whether patients received postoperative CP at all, if so on which post-operative day (POD), for what duration, patient location, incidence of PPCs, and the length of postoperative stay. Statistical analysis was performed using (r 4-4.1) software, using the Chi-squared or Fisher’s Exact test. Results Despite more smokers/ex-smokers in C1(24%) versus C2(8%,p=0.04), only 18/50(36%) C1 patients received CP on POD1, versus 20/36(57%) in C2(p=0.07). Sixteen(32%) C1 patients received no postoperative CP, versus 7(19%) in C2(p=0.19). There were non-significant decreases in PPCs in C2(8%), versus C1(20%)(p=0.13). Three of four patients developing pneumonia in C1, and both those in C2, had no POD1 CP. Wards with higher physiotherapist:patient ratios had more POD1 CP: in C1 12/19(63%)[6/31(20%), p=0.001], and C2 14/15(93%)[6/20(30%) p=0.0001]. Median hospital stay was unchanged (4 days). Conclusion This QI project shows that even with an established enhanced recovery programme, the provision of postoperative chest physiotherapy is not universal. However, it can be improved with an education programme for both healthcare workers and patients.

How English- and Spanish-preferring patients with cancer decide on emergency care.

Despite widespread efforts to reduce emergency department (ED) visits, patients newly diagnosed with cancer often use the ED for commonly anticipated acute care needs. Existing delivery innovations to reduce ED use are underused, and reasons for this are not understood. Patients who recently visited the ED may provide insights into these patterns of care. Qualitative study of semistructured patient interviews from April 2019 to April 2022. We interviewed patients diagnosed with cancer within the prior 6 months from the University of Texas Southwestern Medical Center and its academically affiliated but clinically distinct safety-net health system Parkland Health who had recently visited their respective ED. We completed 29 interviews in English and 11 in Spanish, then analyzed the interviews with the constant comparativemethod. Nearly all patients were unaware of, but interested in using, 24/7 telephone triage and oncology urgent care clinics. Safety-net patients, especially Spanish-preferring patients, reported less access to outpatient cancer teams. Patients did not weigh symptom severity to decide between sites of care, but insured patients were concerned about the cost of hospital visits. Patients did not look forward to visiting the ED but understood its advantages, and for safety-net patients, the ED was the main way to access physicians. When patients were discharged home, they were relieved not to be hospitalized, and the good clinical experience inadvertently reinforced future ED use. Even robust education programs for patients with cancer may have difficulty conveying the availability of innovative clinical services. Patient perspectives on avoidable ED visits may differ from policy makers' definitions.

Assessment of a Therapeutic Education Program for Coronary Patients: Quasi-Experimental Study

Abstract Introduction Therapeutic education is a patient-centered, approach aimed at addressing the patient’s needs and resources. It is intended not only to help the patient understand their illness and treatment but also to empower them to become autonomous. So far, in Tunisia, we lack structures for therapeutic education specifically tailored for coronary patients. In this context, we implemented a Therapeutic Education Program (TEP) for coronary patients visiting the cardiology department at Sahloul University Hospital with the aim of assessing the impact of this program in the short, medium (3 months), and long term (12 months). Methods We conducted a quasi-experimental study on TEP for patients with coronary artery disease over one year at Sahloul University Hospital. Patients were divided into two groups, intervention, and control. Outcome measures included major cardiovascular events, improvement in knowledge, and biological indicators, with statistical analysis performed using SPSS in accordance with ethical considerations. Results The study included 129 patients, of whom 38 underwent a therapeutic education program. TEP demonstrated a significant improvement in knowledge about coronary artery disease, with program satisfaction rated ≥8 on a scale of 0 to 10.Our program also showed improvement in biological parameters, particularly lipid profiles, within the educated group before and after 3 months, such as LDL cholesterol levels (2.53 vs 1.88, P < 0.001), and compared to the control group (1.88 vs 2.9, P = 0.001).Moreover, it led to a significant reduction in long-term cardiovascular events compared to the control group (21.1% vs 59.3%, p < 0.001). Conclusions this study underscores the crucial importance of therapeutic education in enhancing the care and quality of life of coronary patients, highlighting its central role in a proactive, personalized approach to medical management. Key messages • The significance of therapeutic education in empowering patients to understand their condition and become self-reliant. • Need for Structured Programs specifically for coronary patients in Tunisia.

Impact of prior knee surgery on change in knee pain, quality of life, and walking speed following supervised education and exercise therapy: an analysis of 30,545 people with knee osteoarthritis.

To investigate the impact of prior knee surgery on changes in outcomes following an 8-week supervised patient education and exercise therapy program in patients with knee osteoarthritis. Patients were classified according to knee surgery in the most affected knee joint (yes/no) prior to enrolment in the Good Life with osteoArthritis in Denmark (GLA:D®) program. Between-group differences in outcome changes from baseline to 3 months follow-up were evaluated using linear regression stratified by sex. Outcomes were knee pain intensity (VAS, 0-100 mm), joint related quality of life (Knee Injury and Osteoarthritis Outcome Score Quality of Life subscale score (KOOS QOL, 0-100)) and walking speed (40-m fast-paced walk test). To evaluate clinically relevant between-group differences, proportions of patients reaching a threshold of minimal important change in the surgery and non-surgery groups were compared. Among 30,545 patients, 27% (n, 8254) had prior surgery in the most affected knee. The prior surgery and the non-surgery group experienced improvements in all outcomes with minor between-group differences in change in pain intensity (males, 0.03 95% CI - 0.9 to 1.0; females, 1.3 95% CI 0.6 to 2.1); KOOS QOL (males, 0.3 95% CI - 0.4 to 0.9; females 0.02 95% CI - 0.5 to 0.5); and walking speed (males, 0.01 95% CI - 0.01 to 0.02; females 0.01 95% CI 0.003 to 0.02). The responder analysis showed no clinically relevant between-group differences in improvements. Previous knee surgery does not seem to modify the clinical outcome following exercise therapy and patient education in patients with knee osteoarthritis.

Educational needs and its associated factors among patients with ankylosing spondylitis in China: a multicenter cross-sectional study.

Patient education is an important part of ankylosing spondylitis (AS) management. Effective patient education should be targeted at specific priorities and needs of the patients. However, the educational needs of patients with AS in China have not been systematically explored. The purpose of this study was to assess the level of educational needs and analyze associated factors in patients with AS in China. This multicenter cross-sectional study was conducted at five hospitals in China. The Chinese version of the Educational Needs Assessment Tool (ENAT) was used to measure educational needs. Disease activity and physical function were assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Multiple linear regression analysis was used to identify the predictors of educational needs. This study included 163 patients with AS. The mean ENAT score was 86.25 (31.64). Patients wanted to know more about the arthritis process, self-help measures, and treatments. Multiple linear regression analysis indicated that younger age, being female, higher disease activity, and no family history of AS (p < 0.05) were positive predictors of educational needs. Patients with AS in China have considerable educational needs, particularly in the domains of arthritis, self-help, and treatment. Female patients and patients with younger age, higher disease activity, and no family history may have higher educational needs. These factors should be considered when conducting need-based patient education programs. Healthcare professionals should integrate need-based patient education into rheumatology care in the future.

Effects of an Exercise and Lifestyle Education Program in Brazilians living with prediabetes or diabetes: study protocol for a multicenter randomized controlled trial.

Patient education is a crucial strategy for promoting prevention and diabetes self-management since glycemic control achievement involves taking medications, medical nutrition therapy, physical exercise, and behavior changes. However, patient education programs are still barely implemented in low- and middle-income countries. This trial aims to investigate whether a lifestyle education intervention added to physical exercising is superior to sole physical exercising regarding functional capacity, disease-related knowledge, health behaviors, cardiometabolic health parameters, quality of life, depression, and diet quality in individuals with prediabetes or diabetes. Multicenter double-blinded randomized controlled trial with two parallel arms involving 12-week intervention and 6-month follow-up. The eligible individuals (≥ 18years, living with prediabetes or diabetes, literate, no clinical decompensation and/or physical and/or mental limitations that contraindicate physical exercising, written physician permission for exercise, no cognitive impairment, no vision limitations for reading, no confirmed diagnosis of unstable coronary disease or heart failure, no pacemaker and/or implantable cardioverter-defibrillator, no complex ventricular arrhythmias, no intermittent claudication, no recent cardiovascular event or cardiac surgery, and no currently enrolled in a structured exercise program) were recruited from two Brazilian cities and randomized to either (1) an Exercise and Lifestyle Education Program (ExLE) or (2) an Exercise Program (Ex), which can be delivered on-site or remotely based on the participants' internet access and technology literacy. The primary outcomes will be changes in functional capacity and disease-related knowledge. The secondary outcomes will involve changes in health behaviors (health literacy, physical activity level, exercise self-efficacy, and medication adherence) and cardiometabolic health parameters (glycemic control, anthropometric measures, and cardiac autonomic control). Program adherence, satisfaction with the program, diabetes-related morbidity, and changes in quality of life, depression, and diet quality will be the tertiary outcomes. Assessments will occur at baseline, post-intervention, and after 6-month follow-up. If superior effectiveness of ExLE compared to Ex program to improve the outcomes measures is found, this program could be delivered broadly in the Brazilian health system, especially in the primary care facilities where most individuals living with prediabetes and diabetes in our country are assisted. ClinicalTrials.gov, NCT03914924 . Registered on April 16, 2019.

Managements for perioperative anxiety in patients with gastrointestinal cancers.

Gastrointestinal (GI) cancers are the most common malignancies, while surgical intervention remains the sole therapeutic approach offering the possibility of a definite cure for cancer. Perioperative anxiety negatively impacts the recovery of GI cancers. Recently, mounting studies have demonstrated that proper nursing interventions may alleviative perioperative anxious illnesses in patients with GI cancers. We conducted a first comprehensive review to summarize all the current evidence on this topic. After a systematically search in the six common databases, eighteen relevant studies were included for further analysis. The present review highlighted that there is a high prevalence of perioperative anxiety in patients with GI cancers (e.g., colorectal cancer, gastric/stomach cancer, hepatocellular carcinoma, gallbladder cancer, and esophageal cancer), while specific nursing interventions are the reliable methods to reduce postoperative anxiety. These nursing strategies include, but are not limited to, therapeutic listening intervention, implementing perioperative music, predictive nursing, progressive relaxation exercises, psychological interventions in the nursing care, comprehensive nursing, continuous nursing care, video-based nursing education, multidisciplinary cooperative continuous care, accelerated rehabilitation nursing, TCM nursing, evidence-based early warning nursing, target nursing care, and high-quality nursing. Since several limitations existed in the eligible studies as well as in this review, a well-designed multicenter RCT with large sample size is still warranted for the confirmation of nursing intervention for managing perioperative anxiety in patients with GI cancers. Also, future studies should focus on the long-term effects of relevant interventions, specific patient populations, multidisciplinary approaches, technological innovations, and educational programs.

Checkpoint inhibitor therapy: Immune-related adverse event management.

Treatment with immune checkpoint inhibitors for cancer is associated with a high prevalence of multiple immune-related toxicities. Immune-related adverse events (irAEs) can occur anytime during treatment and up to 3 months after treatment. This article discusses checkpoint inhibitor therapy and describes the implementation of a patient education program focused on recognizing immunotherapy irAEs and their toxicities.

Infection prevention in home dialysis

Purpose of review Among patients with kidney failure, home dialysis modalities, including peritoneal dialysis (PD) and home hemodialysis (HHD) provide several individual and healthcare system benefits over in-center hemodialysis (HD). Infection remains a major source of morbidity and mortality in this population, and a core outcome of critical importance to patients, caregivers, and kidney health professionals. This narrative review provides evidence-based measures for infection prevention among individuals receiving home dialysis, with a particular emphasis on dialysis and access-related infections. Recent findings Patient and care partner education and training is an important and major theme for infection prevention in home dialysis. In PD, identifying and managing modifiable risk factors for infections such as hypokalemia, constipation, use of gastric acid suppressants, and domestic pets, along with the use of antimicrobial prophylaxis, when indicated, can substantially reduce peritonitis risk. Reducing the use of central venous catheters (CVC), and duration of CVC dependence is the most effective means of prevention of HD access-related bloodstream infections in individuals receiving HHD. For arteriovenous fistula cannulation, rope ladder technique is associated with lower risk of infection compared to buttonhole cannulation. Summary Developing and instituting a well structured and evidence-based patient training and education program within home dialysis units is the most important measure in preventing and reducing dialysis and access-related infections. Kidney care providers should be familiar with different infection risk factors among individuals receiving home dialysis.

TVE in the management of rare diseases in hematology: raising the "Dephi" bar

Launched in 2022 at the Policlinique d'hématologie et d'immunologie (PHI) of the Centre hospitalier(CH) Saint-Louis, the therapeutic patient education (TPE) program for patients suffering from rare hematology pathologies is continuing to develop. It has led to the creation ofan TPE team. To date, two workshops are up and running, and a third is nearing completion.

Facilitators and challenges of implementing a digital patient education programme for rheumatoid arthritis into clinical practice

BackgroundThe integration of telehealth interventions into clinical practice is frequently delayed, hindering the full adoption. Previously, we developed a digital patient education (PE) programme for self-management in rheumatoid arthritis (RA). While the programme design considered crucial factors to ensure the likelihood of success in clinical practice, there is a need for a systematic evaluation of implementation perspectives. The purpose of this study was to explore perspectives crucial to implementation of a digital PE programme in clinical practice.MethodsThe non-adoption, abandonment, scale-up, spread and sustainability (NASSS) framework was used to evaluate the successes and challenges of implementing the digital PE programme. We included a data set consisting of qualitative focus group discussions involving study nurses, rheumatologists, and leaders from rheumatology departments. Data analysis was guided by a deductive content analysis approach. Further we included data from earlier studies pertaining to the programme’s implementation, comprising the programme development process, a randomized controlled trial evaluating the programme’s effectiveness, and a qualitative study exploring patients’ perspectives of the programme.ResultsFacilitators and challenges of importance to implementation of digital PE were identified. While a wide range of patients could benefit from using digital PE, future implementation should aim for an even broader group than those studied. Both patients and healthcare providers embraced the technology, and the fact that it did not require specific technical skills enhances its potential for success. However, offering digital PE should be based on individual assessments, and expanding its use will require organizational adjustments. An adaptable structure is needed to accommodate unforeseen care needs that may arise following the use of digital PE at home. There was indication of some reluctance among healthcare providers toward the programme shown by concerns about changing roles, which could impact the adoption of the program.ConclusionsThe design and ease of use of the technology, the program’s effectiveness, its availability, and the potential to release healthcare resources may encourage the implementation of digital patient education. Challenges associated with implementing this mode of care pertains to the condition and the patient population, user adoption of the technology, and the organization of patient education.Trial registrationThe study is registered by the Central Denmark Region Scientific Committee (no. 1-16-02-52-19).

The role of complex patient education program in heart failure care

The role of complex patient education program in heart failure care

Educational Programs for Patients with Diabetes: Challenges and Effectiveness

Diabetes self-management education (DSME) is integral to managing diabetes, a chronic condition affecting millions globally. DSME programs aim to equip patients with essential knowledge and skills to manage their diabetes effectively and enhance their quality of life. This review assesses the challenges and effectiveness of current DSME programs. Key challenges include a lack of individualization, cultural and socioeconomic barriers, inadequate health literacy, and difficulties in achieving sustained behavioral change. Despite these challenges, DSME programs have shown potential in improving clinical outcomes, enhancing quality of life, and being cost-effective. Effective strategies to improve DSME include personalizing education to meet individual needs, integrating behavioral support techniques, addressing cultural and socioeconomic factors, and utilizing digital technologies. Addressing these challenges through tailored, evidence-based approaches and ongoing support can enhance the impact of DSME programs. Future research should focus on refining these strategies and exploring innovative methods to optimize diabetes education. Keywords: Diabetes self-management education (DSME), Diabetes management, Patient education, Behavioral change

Education for fatigue management in people with multiple sclerosis: Systematic review and meta-analysis.

Fatigue is a common and disabling symptom in multiple sclerosis (MS). Educational interventions have shown potential to reduce fatigue. The aim was to systematically review the current best evidence on patient education programmes for MS-related fatigue. This was a systematic review and meta-analysis following Cochrane methodology. A systematic search was conducted in eight databases (September 2023). Moreover, reference lists and trial registers were searched and experts in the field were contacted. Randomized controlled trials were included evaluating patient education programmes for people with MS with the primary aim of reducing fatigue. In total, 1176 studies were identified and assessed by two independent reviewers; 15 studies (1473 participants) were included. All interventions provided information and education about different aspects of MS-related fatigue with different forms of application, some with components of psychological interventions. Amongst those, the most frequently applied were cognitive behavioural therapy (n = 5) and energy-conservation-based approaches (n = 4). Studies differed considerably concerning mode of intervention delivery, number of participants and length of follow-up. Interventions reduced fatigue severity (eight studies, n = 878, standardized mean difference -0.28; 95% confidence interval -0.53 to -0.03; low certainty) and fatigue impact (nine studies, n = 824, standardized mean difference -0.21; 95% confidence interval -0.42 to 0.00; moderate certainty) directly after the intervention. Mixed results were found for long-term effects on fatigue, for secondary endpoints (depressive symptoms, quality of life, coping) and for subgroup analyses. Educational interventions for people with MS-related fatigue may be effective in reducing fatigue in the short term. More research is needed on long-term effects and the importance of specific intervention components, delivery and context.

Evaluation of a digital patient education programme in patients with coronary artery disease, a survey-based study

IntroductionPatient education programmes focusing on risk factor modification and lifestyle changes are well established as part of cardiac rehabilitation in patients with coronary artery disease (CAD). As participation rates are low, digital patient education programmes (DPE) are interesting alternatives to increase access. Understanding patients’ perceptions of DPE are important in terms of successful implementation in clinical practice but are not well known. Therefore, the aim of this study was to assess patients’ perceptions of using a DPE in terms of end-user acceptance and usability, perceived significance for lifestyle changes and secondary preventive goal fulfilment in patients with CAD.MethodsThis was a cross-sectional survey-based study. The survey was distributed to all 1625 patients with acute coronary syndrome or chronic CAD with revascularisation, who were registered users of the DPE between 2020 and 2022 as part of cardiac rehabilitation. The survey contained 64 questions about e.g., acceptance and usability, perceived significance for making lifestyle changes and secondary preventive goal fulfilment. Patients who had never logged in to the DPE received questions about their reasons for not logging in. Data were analysed descriptively.ResultsA total of 366 patients (mean age: 69.1 ± 11.3 years, 20% female) completed the survey and among those 207 patients (57%) had used the DPE. Patients reported that the DPE was simple to use (80%) and improved access to healthcare (67–75%). A total of 69% of the patients were generally satisfied with the DPE, > 60% reported that the DPE increased their knowledge about secondary preventive treatment goals and approximately 60% reported having a healthy lifestyle today. On the other hand, 35% of the patients would have preferred a hospital-based education programme. Among the 159 patients (43%) who had never used the DPE, the most reported reason was a perceived need for more information about how to use the DPE (52%).ConclusionsThis study shows an overall high level of patient acceptance and usability of the DPE, which supports its continued development and long-term role in cardiac rehabilitation in patients with CAD. Future studies should assess associations between participation in the DPE and clinical outcomes, such as secondary preventive goal fulfilment and hospitalisation.

52865 Effectiveness of virtual Atopic dermatitis patient education programs – A systematic review and meta-analysis

52865 Effectiveness of virtual Atopic dermatitis patient education programs – A systematic review and meta-analysis

Implementing management of the physical fitness education program for the drug rehabilitation patients in drug addict therapy centre

Abstract. This research analyses the urgency of Implementation of Physical Fitness Education Program Management for Drug Rehabilitation Patients at the Bidayatussalikin Islamic Boarding School (BIBS) Drug Addict Therapy House in Indonesia. This research was a mixed-method research. The quantitative sample consisted of 65 BIBS drug rehabilitation students. The qualitative sample included 6 expert informants. The conclusion is the implementation of physical fitness education programme management as a means of accelerating non-medical rehabilitation for students as former drug addicts needs to be implemented. This programme can be used as a means of accelerating the non-medical healing process through; strengthening physical fitness components, repairing the body's nerve cells, encouraging the release of the hormones dopamine and endorphins that trigger happiness, reducing stress, managing emotions, stabilising mood, channeling positive energy, avoiding empty thoughts, helping restore damaged memory, and entertaining the students as former drug addicts. The conclusion of this study emphasizes the importance of implementing a structured physical fitness education pro-gram in drug rehabilitation centers. The findings confirm that such programs not only provide significant physical health benefits, but also support psychological recovery and encourage positive routines for patients. Physical fitness programs, integrated in drug rehabilitation strategies, should be considered a crucial and indispensable component, due to their contribution to physical and mental well-being during the recovery process. Research has also shown the integral role of rehabilitation in helping individuals suffering from substance use disorders to achieve recovery and pre-vent relapse. By incorporating approaches that cover physical, psychological, social, and spiritual aspects, rehabilitation programs can effectively support the holistic well-being and successful recovery of individuals undergoing rehabili-tation from substance dependence. Keywords: Urgency; Management of Physical Fitness Education Programs; The Drug Rehabilitation Patients

Efficacy of denervation for osteoarthritis in the proximal interphalangeal joint (DOP): protocol of a randomized controlled trial

BackgroundOsteoarthritis (OA) contributes increasingly to disability worldwide. There is ample high-quality research on the treatment of knee and hip OA, whereas research on surgical and non-surgical treatment in hand OA is sparse. Limited evidence suggests that education and exercise may improve pain, function, stiffness, and grip strength in hand OA. The established surgical options in hand OA have disadvantages. Prostheses preserve motion but have a high complication rate, whereas fusions decrease function due to limited movement. There is an unmet need for high-quality research on treatment options for hand OA and a need for the development of effective and safe movement-sparing therapies.This study aims to compare the effects of a motion-preserving surgical treatment (denervation of the proximal interphalangeal (PIP) joint) with a patient education and exercise program on patient-reported outcomes and objective function in painful PIP OA.MethodsIn this parallel-group, two-armed, randomized, controlled superiority trial (RCT), 90 participants are assigned to surgical PIP joint denervation or education and exercise. Pain on load 1 year after intervention is the primary outcome measure. Secondary outcome measures include pain at rest, Patient-Rated Wrist and Hand Evaluation (PRWHE), HQ8 score, EQ5D-5L, objective physical function, complications, two-point discrimination, Mini Sollerman, consumption of analgesics, and the need for further surgery. Assessments are performed at baseline, 3 and 6 months, and 1 year after intervention.DiscussionThere are no previous RCTs comparing surgical and non-surgical treatment in PIP OA. If patient education plus exercise or PIP denervation improve function, these treatments could be implemented as first-line treatment options in PIP OA. However, if denervation does not achieve better results than non-surgical treatment, it is not justified to use in PIP OA.Trial registrationProspectively registered in ClinicalTrials.gov (NCT05980793) on 8 August 2023. URL https://classic.clinicaltrials.gov/ct2/show/NCT05980793.

Mitigating and preventing perioperative opioid-related harm.

Although necessary for treatment of acute pain, opioids are associated with significant harm in the perioperative period and further intervention is necessary perioperatively to mitigate opioid-related harm. Opioid-naive patients are often first exposed to opioids when undergoing surgery, which can result in significant harm. Despite their benefits in reducing acute postsurgical pain, they are also associated with risks ranging from mild (e.g., pruritis, constipation, nausea) to potentially catastrophic (e.g. opioid-induced ventilatory impairment, respiratory depression, death). Overprescribing of opioids can lead to opioid diversion and drug driving. In this review, we will discuss opioid-related harm and what strategies can be used perioperatively to mitigate this harm. Interventions such as optimizing nonopioid analgesia, implementing Enhanced Recovery after Surgery programs, effective respiratory monitoring, patient education and opioid stewardship programs will be discussed. We will review policy and guidelines regarding perioperative opioid management and identify challenges and future directions to mitigate opioid-related harm.