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Opioid Discharge Prescription Guideline Satisfies Most Patients

TUESDAY, March 16, 2021 -- A patient-centered opioid discharge prescription guideline satisfies 93 percent of patients undergoing surgery, according to a research letter published online Feb. 25 in the Journal of the American College of Surgeons.

Eleah D. Porter, M.D., from the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, and colleagues prospectively enrolled 229 patients admitted for 48 hours or longer after elective general, colorectal, urologic, gynecologic, or thoracic surgery. Based on their usage the day before discharge, patients received a prescription of both nonopioid analgesics and opioids at discharge. If no opioid refills were obtained, patients' opioid pain medication needs were considered to be satisfied.

The researchers found that 93 percent of the patients were satisfied with the opioid guideline. In lower opioid usage groups, satisfaction was significantly higher: 99 percent for those receiving 0 oral morphine milligram equivalents (MMEs), 90 percent for those receiving 1 to 29 MMEs, and 82 percent for those receiving 30 MMEs or greater. Nonopioid analgesics were used by 95 percent of the patients. Overall, 60 percent of patients had leftover pills; 83 percent used a U.S. Food and Drug Administration-compliant method for disposal, with 51 percent using the convenient drop box. Only 7 percent of the prescribed pills were kept by patients.

"This finding means that this guideline can be used for a wide variety of operations to guide surgeons on how many opioids to prescribe when sending patients home after surgery," a coauthor said in a statement.

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