Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative Registry
Objective:. To evaluate opioid consumption for 21 procedures over 4 years from the Michigan Surgical Quality Collaborative (MSQC) registry and update post-discharge prescribing guidelines. Background:. Opioids remain a common treatment for postoperative pain of moderate-to-severe intensity not adequ...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2024-12-01
|
| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000517 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832589722984120320 |
|---|---|
| author | Ashwin J. Kulkarni, BS Vidhya Gunaseelan, MBA, MS, MHA Chad M. Brummett, MD Jennifer Waljee, MD, MPH, MSc Michael Englesbe, MD Mark C. Bicket, MD, PhD |
| author_facet | Ashwin J. Kulkarni, BS Vidhya Gunaseelan, MBA, MS, MHA Chad M. Brummett, MD Jennifer Waljee, MD, MPH, MSc Michael Englesbe, MD Mark C. Bicket, MD, PhD |
| author_sort | Ashwin J. Kulkarni, BS |
| collection | DOAJ |
| description | Objective:. To evaluate opioid consumption for 21 procedures over 4 years from the Michigan Surgical Quality Collaborative (MSQC) registry and update post-discharge prescribing guidelines.
Background:. Opioids remain a common treatment for postoperative pain of moderate-to-severe intensity not adequately addressed by nonopioid analgesics, but excessive prescribing correlates with increased usage. This analysis provides updates and compares patient-reported consumption in response to new guidelines.
Methods:. We examined data from the MSQC registry for opioid-naive adult patients undergoing surgery between January 1, 2018, and October 31, 2021. The primary outcome was patient-reported opioid consumption in oxycodone 5 mg equivalents. Guidelines were anchored to the 75th percentile of consumption, updating previous guidelines from January 2020 based on data from January 1, 2018, to May 31, 2019.
Results:. 39,493 opioid-naive surgical patients (average age 53.8 years [SD 16.4], 56.3% female, 19.1% non-White, 43.9% with public insurance) were included. Guidelines did not change for 7 of the 16 procedures including the most common procedures: minor hernia, laparoscopic cholecystectomy, laparoscopic appendectomy, and laparoscopic hysterectomy. Recommended prescribing ranges were lower for 9 procedures, with most (8) procedures having a reduction of 5 pills. Prescribing guidelines were developed for 5 new procedures. All procedures had upper-limit guidelines of 10 pills or less.
Conclusions:. For most procedures, patient-reported opioid consumption decreased between 2018 and 2021 when compared to the period between 2018 and 2019. New guidelines were established for a dozen procedures to balance maximizing pain control with reducing harms from inappropriate prescribing. |
| format | Article |
| id | doaj-art-bad9ca1e8e9944af9eeda5c5ba4a9b11 |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-bad9ca1e8e9944af9eeda5c5ba4a9b112025-01-24T09:18:58ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-12-0154e51710.1097/AS9.0000000000000517202412000-00018Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative RegistryAshwin J. Kulkarni, BS0Vidhya Gunaseelan, MBA, MS, MHA1Chad M. Brummett, MD2Jennifer Waljee, MD, MPH, MSc3Michael Englesbe, MD4Mark C. Bicket, MD, PhD5From the * University of Michigan Medical School, Ann Arbor, MI† Department of Anesthesiology, University of Michigan, Ann Arbor, MI† Department of Anesthesiology, University of Michigan, Ann Arbor, MI§ Department of Surgery, University of Michigan, Ann Arbor, MI.§ Department of Surgery, University of Michigan, Ann Arbor, MI.† Department of Anesthesiology, University of Michigan, Ann Arbor, MIObjective:. To evaluate opioid consumption for 21 procedures over 4 years from the Michigan Surgical Quality Collaborative (MSQC) registry and update post-discharge prescribing guidelines. Background:. Opioids remain a common treatment for postoperative pain of moderate-to-severe intensity not adequately addressed by nonopioid analgesics, but excessive prescribing correlates with increased usage. This analysis provides updates and compares patient-reported consumption in response to new guidelines. Methods:. We examined data from the MSQC registry for opioid-naive adult patients undergoing surgery between January 1, 2018, and October 31, 2021. The primary outcome was patient-reported opioid consumption in oxycodone 5 mg equivalents. Guidelines were anchored to the 75th percentile of consumption, updating previous guidelines from January 2020 based on data from January 1, 2018, to May 31, 2019. Results:. 39,493 opioid-naive surgical patients (average age 53.8 years [SD 16.4], 56.3% female, 19.1% non-White, 43.9% with public insurance) were included. Guidelines did not change for 7 of the 16 procedures including the most common procedures: minor hernia, laparoscopic cholecystectomy, laparoscopic appendectomy, and laparoscopic hysterectomy. Recommended prescribing ranges were lower for 9 procedures, with most (8) procedures having a reduction of 5 pills. Prescribing guidelines were developed for 5 new procedures. All procedures had upper-limit guidelines of 10 pills or less. Conclusions:. For most procedures, patient-reported opioid consumption decreased between 2018 and 2021 when compared to the period between 2018 and 2019. New guidelines were established for a dozen procedures to balance maximizing pain control with reducing harms from inappropriate prescribing.http://journals.lww.com/10.1097/AS9.0000000000000517 |
| spellingShingle | Ashwin J. Kulkarni, BS Vidhya Gunaseelan, MBA, MS, MHA Chad M. Brummett, MD Jennifer Waljee, MD, MPH, MSc Michael Englesbe, MD Mark C. Bicket, MD, PhD Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative Registry Annals of Surgery Open |
| title | Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative Registry |
| title_full | Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative Registry |
| title_fullStr | Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative Registry |
| title_full_unstemmed | Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative Registry |
| title_short | Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative Registry |
| title_sort | postoperative opioid consumption after discharge an update from the michigan surgical quality collaborative registry |
| url | http://journals.lww.com/10.1097/AS9.0000000000000517 |
| work_keys_str_mv | AT ashwinjkulkarnibs postoperativeopioidconsumptionafterdischargeanupdatefromthemichigansurgicalqualitycollaborativeregistry AT vidhyagunaseelanmbamsmha postoperativeopioidconsumptionafterdischargeanupdatefromthemichigansurgicalqualitycollaborativeregistry AT chadmbrummettmd postoperativeopioidconsumptionafterdischargeanupdatefromthemichigansurgicalqualitycollaborativeregistry AT jenniferwaljeemdmphmsc postoperativeopioidconsumptionafterdischargeanupdatefromthemichigansurgicalqualitycollaborativeregistry AT michaelenglesbemd postoperativeopioidconsumptionafterdischargeanupdatefromthemichigansurgicalqualitycollaborativeregistry AT markcbicketmdphd postoperativeopioidconsumptionafterdischargeanupdatefromthemichigansurgicalqualitycollaborativeregistry |