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Am J Otolaryngol ; 42(4): 102991, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33640800

RESUMEN

PURPOSE: In opioid-naive patients, many low-risk surgical procedures are associated with an increased risk of chronic opioid use. The goal of this quality improvement project was to reduce the amount of opioid prescriptions after commonly performed surgeries in otolaryngology. MATERIALS AND METHODS: Pre-intervention opioid prescribing state was measured using anonymous provider and patient surveys, as well as pharmacy provider prescription data. Next, this information was used to develop an opioid prescription protocol that both standardized opioid prescribing practices and encouraged multimodal analgesia following routine surgery. Finally, post-intervention data were gathered and compared to pre-intervention data to assess changes in prescribing patterns. RESULTS: By patient survey, the worst pain and average pain after surgery (scale of 1-10) were unchanged after the intervention (5.1 to 4.8, p = 0.52; 4.1 to 3.6, p = 0.35, respectively). Post-intervention, 41% of patients reported receiving no opiates, whereas pre-intervention 100% of patients surveyed received opiates. The amount of ibuprofen and acetaminophen prescribed post-intervention increased 113% and 71%, respectively. By survey, the average number of opioid doses decreased from 24.0 ± 7.0 to 18.4 ± 6.6 (p = 0.018). CONCLUSIONS: The implementation of a standardized physician opioid prescription protocol did not affect patient pain perceptions, resulted in an increase in multimodal analgesia prescription, and increased provider awareness of opioid over prescription.


Asunto(s)
Analgésicos Opioides/administración & dosificación , Prescripciones de Medicamentos/estadística & datos numéricos , Reducción Gradual de Medicamentos , Utilización de Medicamentos/estadística & datos numéricos , Procedimientos Quirúrgicos Otorrinolaringológicos/efectos adversos , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/prevención & control , Mejoramiento de la Calidad , Calidad de la Atención de Salud , Acetaminofén/administración & dosificación , Humanos , Ibuprofeno/administración & dosificación , Dolor Postoperatorio/etiología , Seguridad del Paciente
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