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Educational material may help reduce opioid consumption after hand surgery
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SAN FRANCISCO — Physician guidelines and patient handouts helped to significantly reduce the number of prescription opioid pills while maintaining high patient satisfaction and a low refill rate, according to results presented at the American Society for Surgery of the Hand Annual Meeting.
C. Liam Dwyer, MD, and colleagues allowed surgeons to prescribe opioids based on written guidelines, with recommendations from 10 pills to 15 pills for carpal tunnel release and 20 pills to 30 pills for volar locked-plating procedures.
“All patients received an educational handout postoperatively focused on opioid use, safety and disposal,” Dwyer said in his presentation. “As well, they were provided a daily pain diary for daily pain scores to count the number of opioid pills consumed and the number of over-the-counter [OTC] pills consumed.” He added patients were to complete a pain catastrophizing scale survey. Overall, 121 patients were included in the carpal tunnel arm of the study and 24 in the volar locked-plating arm of the study.
Dwyer noted a decrease in the average prescription of opioids from the year prior. He added an average of three opioid pills and 11 OTC pills were consumed in the carpal tunnel group and an average of 16 opioid pills and 20 OTC pills consumed in the volar locked-plating group.
When it came to refills, Dwyer noted two patients and six patients requested refills in the carpal tunnel group and the volar locked plating group, respectively. Patient satisfaction remained high at 96% in the carpal tunnel group and 88% in the volar locked plating group, he said. Of the total prescribed pills, 55% were unconsumed by patients and 9% of patients recorded appropriate disposal.
“Other findings from our study include that patients with high pain catastrophizing scores required [a] significantly higher number of opioid pills in both the carpal tunnel arm, as well as the volar locked-plating arm,” Dwyer said. – by Casey Tingle
Reference:
Dwyer CL, et al. Paper #5. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 7-9, 2017; San Francisco.
Disclosure: Dwyer reports that he has no relevant financial disclosures.