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Opioid prescribing after micrographic surgery decreases at University of Utah
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Opioid prescribing patterns after micrographic surgery by surgeons at University of Utah have decreased since 2010, according to a retrospective chart review.
“The decrease in the opioid prescriptions provided shows that awareness of practice patterns in comparison to one’s peers may lead to a positive change in behavior,” Jessica M. Donigan, MD, from the School of Medicine at the University of Utah, told Healio Dermatology.
The University of Utah examined opioid prescribing patterns in 2010 across its micrographic surgeons and found that 35% of patients received an average of 10 pills.
In the same study, 64% respondents from the American Society for Dermatologic Surgery reported prescribing opioids after less than 11% of micrographic surgeries, “suggesting that University of Utah surgeons were overprescribing opioids based on what their peers self-reported,” according to Donigan and colleagues.
In the current study, spanning from February 2017 to May 2017, 100 patient records from each of four micrographic surgeons at the institution were reviewed. Surgeons were arbitrarily designated as A, B, C or D, and two surgeons were included in the original study.
The 400 unique patient encounters involved 383 patients and 430 surgical sites.
An opioid was prescribed after 47 encounters (12%) and was most frequently hydrocodone 5 mg/acetaminophen 325 mg, with a mean of nine pills prescribed, according to researchers.
Surgeon A prescribed an opioid in 6% of patients, followed by surgeon B at 7%, surgeon C at 16% and surgeon D at 18%. Surgeon A prescribed a mean of 15 pills, surgeon B seven pills, surgeon C nine pills and surgeon D eight pills.
Researchers identified that younger age, increasing defect size, the type of defect repair and particular surgeons were identified as predictors of opioid prescription.
“It is important to note that the ability to prescribe opioids electronically did not lead to an increase in opioid prescriptions,” Donigan said. “Although not specifically looked at in this study, having the ability to prescribe these medications electronically may actually lead to a decrease in erroneous opioid prescriptions as providers won’t feel as though if they don’t provide a prescription during the visit it will be difficult to do so later.” – by Abigail Sutton
Disclosures: The authors report no relevant financial disclosures.