Provider education decreases opioid prescribing after pediatric umbilical hernia repair.
J Pediatr Surg
; 55(7): 1319-1323, 2020 Jul.
Article
em En
| MEDLINE
| ID: mdl-31109731
ABSTRACT
PURPOSE:
To improve opioid stewardship for umbilical hernia repair in children.METHODS:
An educational intervention was conducted at 9 centers with 79 surgeons. The intervention highlighted the importance of opioid stewardship, demonstrated practice variation, provided prescribing guidelines, encouraged non-opioid analgesics, and encouraged limiting doses/strength if opioids were prescribed. Three to six months of pre-intervention and 3â¯months of post-intervention prescribing practices for umbilical hernia repair were compared.RESULTS:
A total of 343 patients were identified in the pre-intervention cohort and 346 in the post-intervention cohort. The percent of patients receiving opioids at discharge decreased from 75.8% pre-intervention to 44.6% (pâ¯<â¯0.001) post-intervention. After adjusting for age, sex, umbilicoplasty, and hospital site, the odds ratio for opioid prescribing in the post- versus the pre-intervention period was 0.27 (95% CIâ¯=â¯0.18-0.39, pâ¯<â¯0.001). Among patients receiving opioids, the number of doses prescribed decreased after the intervention (adjusted mean 14.3 to 10.4, pâ¯<â¯0.001). However, the morphine equivalents/kg/dose did not significantly decrease (adjusted mean 0.14 to 0.13, pâ¯=â¯0.20). There were no differences in returns to emergency departments or hospital readmissions between the pre- and post-intervention cohorts.CONCLUSIONS:
Opioid stewardship can be improved after pediatric umbilical hernia repair using a low-fidelity educational intervention. TYPE OF STUDY Retrospective cohort study. LEVEL OF EVIDENCE Level II.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Prescrições de Medicamentos
/
Padrões de Prática Médica
/
Cirurgiões
/
Hérnia Umbilical
/
Analgésicos Opioides
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article