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Prescription protocols may reduce mean oral morphine equivalents given by residents, interns
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BOSTON — Implementation of an evidence-based narcotic prescription protocol may reduce the mean oral morphine equivalents per prescription given by surgical residency trainees, according to results presented here.
“We think that residents and medical students should receive formal opioid-prescribing education,” Craig R. Moores, MD, said in his presentation at the American Society for Surgery of the Hand Annual Meeting. “The protocols can assist to standardize prescribing habits and partnering with statewide prescription monitoring programs is an ideal way to monitor the success of protocols and other interventions that you can implement.”
Moores and colleagues developed and instituted an evidence-based narcotic prescription protocol for the plastic surgery training program at the Medical University of South Carolina. Researchers identified three patient groups based on patient history of narcotic use, surgical procedure and a combination of narcotic, NSAID and adjuncts were recommended for each group. For standardization, researchers converted all narcotic prescriptions to oral morphine equivalents.
“We used the prescription monitoring program from our state to get anonymous prescribing data for our residents and interns,” Moores said. “We looked at the 5.5 months following the protocol and compared it to the 11 months prior to the protocol.”
Pre-protocol, Moores noted a significant variation in the prescribing habits of the residents with little standardization in prescribing habits. Despite one resident who had a slight increase in opioid prescribing post-protocol, according to Moores, four of five residents had significant reduction in opioid prescriptions and residents showed more standardization in their prescribing habits.
“After the protocol ... for the residents, [prescribing] reduced, on average, from 287 to 184,” Moores said. “For the interns, it reduced from 441 to 319, both of which were significant.” – by Casey Tingle
Reference:
Moores, CR. Paper 9. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 13-15, 2018; Boston.
Disclosure: Moores reports no relevant financial disclosures.