You have accessJournal of UrologyCME1 May 2022PD54-01 REDEFINING OPIOID USE AFTER PROSTATECTOMY: RESULTS FROM THE IMPLEMENTATION OF A STATEWIDE OPIOID-FREE PAIN OPTIMIZATION PATHWAY Udit Singhal, Ji Qi, Kevin Ginsberg, Alice Semerjian, Thomas Maatman, John Dibianco, Todd M. Morgan, Jeffrey S. Montgomery, Mary Nowlin, Anna Johnson, Stephanie Ferrante, James E. Montie, William Johnston, Mohammad Jafri, Bradley Rosenberg, Richard Sarle, and Arvin K. George Udit SinghalUdit Singhal More articles by this author , Ji QiJi Qi More articles by this author , Kevin GinsbergKevin Ginsberg More articles by this author , Alice SemerjianAlice Semerjian More articles by this author , Thomas MaatmanThomas Maatman More articles by this author , John DibiancoJohn Dibianco More articles by this author , Todd M. MorganTodd M. Morgan More articles by this author , Jeffrey S. MontgomeryJeffrey S. Montgomery More articles by this author , Mary NowlinMary Nowlin More articles by this author , Anna JohnsonAnna Johnson More articles by this author , Stephanie FerranteStephanie Ferrante More articles by this author , James E. MontieJames E. Montie More articles by this author , William JohnstonWilliam Johnston More articles by this author , Mohammad JafriMohammad Jafri More articles by this author , Bradley RosenbergBradley Rosenberg More articles by this author , Richard SarleRichard Sarle More articles by this author , and Arvin K. GeorgeArvin K. George More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002631.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The opioid epidemic has intensified focus on alternative pain management strategies after surgery. While prior findings have shown a decrease in opioid prescriptions after implementation of an opioid-limited pathway after radical prostatectomy (RP), minimal data exist evaluating a completely opioid-free pathway. We report on the statewide implementation of the Michigan opioid-free pain optimization pathway (MPOP) after RP, and determine the impact on post-operative opioid consumption and pain control. METHODS: MPOP was developed statewide in collaboration with the Michigan Opioid Prescribing Engagement Network and implemented starting October 2020. Baseline pain and opioid use were assessed preoperatively and 1-month post-RP. Opioid prescribing pre- and post-MPOP implementation was evaluated, including need for opioid prescription at discharge, refills, new outpatient opioid use, total opioid use, and overall pain control. Opioids were converted to total morphine milligram equivalents (MME) for standardization. Proportions were compared with the Chi-squared test and continuous measures with the Wilcoxon rank-sum test. RESULTS: A total of 2286 patients from 24 practices who underwent RP and completed the 1-month PRO survey were included. Proportion of patients by contributing practice discharged on the opioid-free pathway ranged from 0% to 81% (Figure 1). Prior to MPOP implementation, 82% (n=1460/1782) of patients were prescribed opioids at discharge, compared to 56% (281/504) post-MPOP (p <0.001). After MPOP implementation, 2.7% of those discharged without opioids requested a prescription within 30 days. Among patients who received opioids, median opioid prescriptions remained stable pre vs post implementation (median=45 MME/patient, IQR 37.5-75). No significant differences were observed in postoperative pain scores between patients treated before vs after MPOP implementation (p=0.13). An estimated 16,000 fewer tablets of 5 mg oxycodone were prescribed due to MPOP implementation. CONCLUSIONS: Implementation of a statewide opioid-free pain optimization pathway after RP led to decreased opioid prescriptions at discharge, reduced opioid consumption, and similar overall pain control reported by patients. Source of Funding: Blue Cross Blue Shield of Michigan © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e915 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Udit Singhal More articles by this author Ji Qi More articles by this author Kevin Ginsberg More articles by this author Alice Semerjian More articles by this author Thomas Maatman More articles by this author John Dibianco More articles by this author Todd M. Morgan More articles by this author Jeffrey S. Montgomery More articles by this author Mary Nowlin More articles by this author Anna Johnson More articles by this author Stephanie Ferrante More articles by this author James E. Montie More articles by this author William Johnston More articles by this author Mohammad Jafri More articles by this author Bradley Rosenberg More articles by this author Richard Sarle More articles by this author Arvin K. George More articles by this author Expand All Advertisement PDF DownloadLoading ...