Nav: Home

Physician education and guidelines lead to drop in opioids prescribed after hand surgery

March 08, 2018

An educational session on opioid abuse and new prescription guidelines led to a 45 percent decrease in opioids prescribed after hand surgery, according to a study at Hospital for Special Surgery (HSS). The educational session was mandatory for all HSS staff involved in prescribing controlled substances. The hospital also conducted extensive research to develop guidelines for opioid prescription.

The study, "Opioid Prescriber Education and Guidelines Decrease Opioids Prescribed after Ambulatory Hand Surgery," was presented today at the American Academy of Orthopaedic Surgeons Annual Meeting in New Orleans.

"Prescription opioid misuse is an epidemic in the United States with almost 2 million Americans having abused prescription opioid medication. It's now the leading cause of death in adults under 50," said Daniel Osei, MD, a hand surgeon at HSS and senior investigator. "Recent studies demonstrate a consistent over-prescription of opioid medications nationwide. As physicians, we always strive to provide adequate pain control for our patients. But we are also increasingly aware that when there are excess amounts of unused medication, it can be diverted to uses other than treating pain."

Currently, there is no national standardized prescriber education course or postoperative opioid guidelines for ambulatory hand surgery. However, prescriber education previously has been shown to decrease over-prescription on a small scale.

The HSS researchers set out to evaluate the effect of the education session and the hospital's new opioid guidelines on physician prescribing practices after ambulatory hand surgery.

HSS mandated a one- to two-hour education program in November 2016 for all employees qualified to prescribe controlled substances. The hospital also formulated prescribing guidelines after an extensive review of the medical literature on the amount of pain medication commonly needed after hand surgery. The new guidelines, which recommended a specific number of pills based on the type of hand surgery performed, were disseminated to staff in February 2017.

To see if there was a change in prescribing practices, investigators reviewed postoperative opioid prescriptions for patients who underwent ambulatory hand surgery in the two months prior to the mandatory education session; in the two months following physician education; and during the two-month period that followed the dissemination of prescribing guidelines.

A total of 731 ambulatory hand surgeries with postoperative opioid prescriptions for patients were included in the study. All three time periods had a similar ratio of surgery types. Researchers found a 45 percent reduction in opioids prescribed after the education session and distribution of guidelines.

"It would be difficult to overstate the importance of this study. A 45 percent reduction is a huge amount and demonstrates the success of the program in reducing the amount of prescribed narcotics," said Dr. Osei. "Our results suggest that similar standardized education and prescribing guidelines on a national level could reduce the amount of opioids prescribed after ambulatory hand surgery nationwide."

The next step for Dr. Osei and his colleagues at HSS will be an analysis of how well the prescribing practices worked in terms of pain control and patient satisfaction for those in the study. He noted that among his own patients, he did not notice an increase in requests for more pain medication.
-end-
About HSS | Hospital for Special Surgery

HSS is the world's leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the eighth consecutive year) and No. 3 in rheumatology by U.S. News & World Report (2017-2018). Founded in 1863, the Hospital has one of the lowest infection rates in the country, and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State.

In 2017 HSS provided care to 135,000 patients from 80 countries, and performed more than 32,000 surgical procedures. In addition to Patient Care, HSS leads the field in research, innovation, and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair, and tissue regeneration. The HSS Innovation Institute was formed in 2015 to realize the potential of new drugs, therapeutics and devices; the global standard total knee replacement was developed at HSS in 1969, and in 2017 HSS made 130 invention submissions (more than 2x the submissions in 2015). The HSS Education Institute provides continuing medical curriculum to more than 15,000 subscribing musculoskeletal healthcare professionals in 110 countries. Through HSS Global, the institution is collaborating with medical centers worldwide to advance the quality and value of care, and to make world-class HSS care more accessible to more people.

Hospital for Special Surgery

Related Opioid Abuse Articles:

Significant decline in prescription opioid abuse seen among Americans at last
Almost 20 years into the opioid epidemic, there finally is evidence of significant and continual decreases in the abuse of these risky pain medications, according to an analysis of national data being presented at the ANESTHESIOLOGY® 2020 annual meeting.
Opioid use can trigger deafness
Opioid use, particularly in high doses, can cause deafness, according to Rutgers researchers.
Association of state-level opioid-reduction policies with opioid poisonings in kids
Researchers compared the rate of opioid poisonings in children and teens before and after implementation of state-level policies intended to decrease the amount of opioid medications prescribed and distributed.
New molecular probes for opioid receptors
It could be an important step forward in the improvement of pain therapy: Thanks to newly developed molecular probes, the behavior of individual opioid receptors can now be studied in detail.
'Levitating' proteins could help diagnose opioid abuse, other diseases
Researchers at the Precision Health Program have helped develop a new method called 'magnetic levitation' for detecting the density of proteins in the blood -- a method that could vastly improve the rate at which diseases are detected and diagnosed.
MA physician assistant programs adopt first-in-nation partnership to prevent opioid abuse
Morbidity and mortality from prescription and synthetic opioid use and abuse continues to be a U.S. public health issue.
Study reveals urban hotspots of high-schoolers' opioid abuse
A new study from researchers at the Johns Hopkins Bloomberg School of Public Health found that in several cities and counties the proportion of high-schoolers who have ever used heroin or misused prescription opioids is much higher than the national average.
Is opioid treatment available to those who need it most?
The US opioid epidemic is still raging -- it's particularly pronounced in low-income areas and in those where people lack access to health care services, which includes cities in Michigan and across the Rust Belt.
Opioid use disorder in pregnancy: 5 things to know
Opioid use is increasing in pregnancy as well as the general population.
Opioid treatment for teens? Medications can help
Teens who misuse prescription or illicit opioids might benefit from opioid treatment medications, according to a new study led by a Yale researcher.
More Opioid Abuse News and Opioid Abuse Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Warped Reality
False information on the internet makes it harder and harder to know what's true, and the consequences have been devastating. This hour, TED speakers explore ideas around technology and deception. Guests include law professor Danielle Citron, journalist Andrew Marantz, and computer scientist Joy Buolamwini.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.