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Impact of opioid prescribing guidelines on prescribing at discharge from endocrine surgery.

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INTRODUCTION In 2018, our institution implemented opioid prescribing guidelines for endocrine surgery. METHODS We evaluated prescribing trends before and after the guidelines (60 MME following adrenal procedures and 37.5 MME… Click to show full abstract

INTRODUCTION In 2018, our institution implemented opioid prescribing guidelines for endocrine surgery. METHODS We evaluated prescribing trends before and after the guidelines (60 MME following adrenal procedures and 37.5 MME for thyroid/parathyroid procedures) using chi-squared and Wilcoxon Rank-Sum tests. RESULTS We identified 357 patients in the pre-guideline and 397 in the post-guideline period. The proportion discharged with any opioid prescription decreased from 96.1% to 77.3%, p < 0.01, and the median (IQR) prescribed amount decreased from 150.0 (100.0, 200.0) to 50.0 (25.0, 75.0), p < 0.01 overall and within each category. The proportion receiving prescription above the upper guidelines limit also decreased, while opioid refills within 30-day of discharge remained stable (2.8% before and 4.5% after the guidelines, p = 0.21). CONCLUSION Opioid prescribing guidelines for endocrine surgical procedures decreased both the proportion of patients receiving opioids and the amount when prescribed, therefore further supporting the utility of opioid prescribing guidelines in decreasing over-prescription.

Keywords: endocrine surgery; discharge; opioid prescribing; prescribing guidelines

Journal Title: American journal of surgery
Year Published: 2020

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