C. Paffett1, M. Crandall1, B. K. Yorkgitis1 1University of Florida College of Medicine-Jacksonville,Department Of Surgery,JACKSONVILLE, FL, USA
Introduction: As the nation works to improve the opioid epidemic, safer opioid prescribing is needed. Prescriber education is one method to assist with this aim. To gauge current surgical residents’ opioid prescribing practices at a safety-net hospital, a survey was completed prior to a general surgery specific opioid prescribing education (OPE) session. The effectiveness of this OPE was measured through a post-participation survey.
Methods: A voluntary, anonymous survey prior to and after a one-hour OPE session was performed at an urban safety-net hospital. Descriptive statistics and Student’s t-test comparisons of means were performed to analyze the results.
Results:
Twenty-three residents completed the surveys. Eleven (47.8%) completed prior OPE with the most common modality being online (7, 63.6%). No participant performed an opioid risk assessment prior to prescribing opioids. More than half of the residents (14, 60.9%) never used the Prescription Drug Monitoring Program. Less than 1/3 (30.4%) used pre-operative gabinoids (gabapentin or pregabalin) for elective surgeries. Only two residents provided information on unused opioid disposal.
After the OPE, the participants were more likely to prescribe pre-operative gabinoids: 5 sometimes, 9 most of the time and 7 all the time. The mean opioid pills prescribed for laparoscopic cholecystectomy, open inguinal hernia repair, laparoscopic ventral hernia repair and laparoscopic appendectomy were reduced by 2.6 (14.2%), 3.7( 18.9%), 2.6 (13.1%), and 1.1 (7.3%) pills respectively (Table 1).
Conclusion: A short OPE delivered to surgical residents at a safety-net hospital improved the use of preoperative gabinoids and reduced the mean number of opioid pills prescribed after common surgical procedures. While none of these results were statistically significant, there was a consistent reduction in amount of opiates prescribed after OPE. However, clinical significance is important, as a reduction in any amount of opioid medication can help deter misuse and diversion. This suggests surgeons could participate in a specialty specific OPE to assist with opioid prescribing.
