WMJ Vol 123 Issue 1: Postoperative Prescribing Practices Following Gynecologic Surgery

WMJ Vol 123 Issue 1: Postoperative Prescribing Practices Following Gynecologic Surgery

ABSTRACT Background: Opioids prescribed for postoperative pain have exceeded patient need in the United States, playing a significant role in the opioid epidemic. In the preintervention phase of this project (September 2018 March 2019), a chart review and patient survey revealed that patients were prescribed double the number of opioids they consumed following gynecologic surgery. Objective: To ascertain whether an educational intervention recommending opiate prescriptions based on postoperative opioid use decreases gynecologic surgeons opiate prescriptions. Methods: An educational intervention implemented in January 2021 communicated the discrepancy between patient need and medications prescribed and made prescribing recommendations for common gynecologic procedures. A postintervention (February 2021 April 2021) retrospective chart review ascertained postoperative opioid prescribing practices. Residents were surveyed about their prescribing practices in June 2021. Descriptive statistics compared each phase. Results: For laparoscopic hysterectomy, the median morphine milligram equivalent (MME) was 150 (IQR 112.5-166.9) for preintervention and 150 (IQR 112.5-150) postintervention. For vaginal hysterectomy, median MME declined from 150 (IQR 112.5-225) to 112.5 (IQR 112.5-150). For laparoscopic surgery without hysterectomy, the median MME was 75 for both preintervention (IQR 75-120) and postintervention (IQR 60-80). For vaginal surgery without hysterectomy median MME went from 75 (IQR 75-142.5) to 54 (IQR 22.5-112.5). Median MME for hysteroscopy and dilation and curettage was 0 for both phases. When surveyed, residents reported prescribing lower amounts than actual prescribing practices. Conclusions: Despite education informing gynecologic surgeons that their opioid prescribing exceeded patient need, prescribing practices did not change. The difference between actual and resident-reported prescribing practices warrants further investigation.

  • Provider:University of Wisconsin-Madison Interprofessional Continuing Education Partnership
  • Activity Link: https://ce.icep.wisc.edu/node/49257
  • Start Date: 2024-05-03 05:00:00
  • End Date: 2024-05-03 05:00:00
  • Credit Details: AMA PRA Category 1 Credit™️: 1.0 hours
  • Commercial Support: No
  • Activity Type: Journal-based CE
  • CME Finder Type: Other
  • Fee to Participate: No, it's free
  • Measured Outcome: Learner/Team Competence
  • Provider Ship: Jointly Provided
  • Registration: Open to all
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