Mandated Opioid Online Training Course-Does it Impact Opioid Prescription Patterns for Outpatient Endoscopic Urological Surgeries?

ABSTRACT

INTRODUCTION: Opioid addiction is a rising public health crisis. We evaluated if a New York State-mandated online opioid awareness course impacted our urology opioid prescription practices for outpatient endoscopic surgeries. METHODS: We completed a retrospective review of all ambulatory endoscopic cases identified by CPT codes for all adult urology faculty between February 2016 and January 2018. Patients were divided into 2 cohorts, ie pre-mandated and post-mandated training. Patient demographics, procedure details, psychiatric history and postoperative pain prescriptions were collected. Changes in opioid prescription practices prior to and after the mandated online course were reviewed. Chi-square and linear regression analyses were performed. RESULTS: A total of 356 cases were analyzed. After the training course, overall frequency of department opioid prescriptions did not change significantly (47.9% vs 47.5%, p=0.95). However, the percentage of patients receiving an oxycodone/acetaminophen prescription decreased from 90.2% to 63.0% (p <0.001) and the average number of tablets prescribed decreased (8.6 vs 16.9, p <0.001). On multivariate analysis, placement of a ureteral stent, older patient age and higher body mass index were predictors of an opioid prescription. In those patients who had a stent placed, nonopioid prescriptions increased from 42% to 88% (p <0.001). CONCLUSIONS: Overall, the New York State-mandated education session did impact opioid prescription practices for outpatient urological endoscopic surgery at our institution. The largest impact was seen within patients undergoing procedures requiring stent placement, with a decrease in total number of oxycodone/acetaminophen prescriptions and number of tablets prescribed per prescription. These data begin to demonstrate effective interventions that may impact physician practice patterns within opioid research.