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Opioid over-prescription after hiatal hernia surgery attributed to provider practices
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Patients who undergo open and laparoscopic hiatal hernia repair take far less opioids than they are prescribed, a trend that investigators said could be a factor in the proliferation of the opioid epidemic, according to research presented at the American Association for Thoracic Surgery’s 98th Annual Meeting in San Diego.
Alyssa A. Mazurek, of the University of Michigan, and colleagues said there is a need for procedure specific guidelines, as well as improvements in the way patients are educated about dosing and proper disposal of opioids.
“The deadliness of the opioid epidemic has become one of the largest public health crises of our time, and its devastating effects are felt throughout the country,” Mazurek said in a press release. “However, there has been very little investigation into opioid prescribing practices after thoracic surgeries. Further investigation is needed to understand what mechanisms are contributing to excessive prescribing and morbidity, such as opioid dependence, addiction, and narcotic diversion, associated with postoperative opioid use.”
Mazurek and colleagues evaluated survey responses from 61 patients who underwent either open or laparoscopic hiatal hernia repair (HHR) between January and December 2016. Patients responded to questions about their postoperative opioid use and the education they received.
They reported that they only used 52% of the narcotic medications prescribed to them.
Further, just 21% of patients in the open surgery group and 11% in the laparoscopic group reported that they were educated on the proper disposal of opioids.
The investigators attributed opioid over-prescription to wide variation within prescribing, a variety of differing factors that influence prescribing practices among providers, insufficient patient education, inadequate use of adjunct pain medications, and improper disposal of leftover pills.
“It has become clear that surgeons and other health care providers play a major role in the over-prescribing of opioids after surgery,” Mazurek said in the press release. “Given the growing awareness of this epidemic and the willingness of surgeons around the country to address it means we can also play a huge role in reducing excessive opioid prescribing and the number of unused pills that permeate into the community by further understanding prescribing practices and creating procedure-specific guidelines.” – by Alex Young
Reference:
Mazurek AA, et al. Abstract P30. Presented at: Interdisciplinary Autoimmune Summit; April 28-May 1, 2018; San Diego, Calif.
Disclosures:
Healio Gastroenterology and Liver Disease could not confirm the authors’ relevant financial disclosures at the time of reporting.