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Tag: post-surgery opioids

  • Michigan Reduces Opioids After Surgery, Patients Fare Fine

    Michigan Reduces Opioids After Surgery, Patients Fare Fine

    A new study examined information on patient satisfaction and outcomes in the seven months following the release of new opioid prescription guidelines in the state.

    The state of Michigan implemented opioid prescribing guidelines that resulted in people receiving fewer painkillers after surgery—but patients taking fewer pills did not experience more pain after procedures, according to a new study. 

    The study, published in The New England Journal of Medicine, looked at information on patient satisfaction and outcomes in the seven months following the release of new opioid prescription guidelines in Michigan. The study examined results for nearly 12,000 patients, and found that the average number of pills patients were given following a surgery was reduced from 26 to 18. 

    Controlling The Numbers

    Despite the drastic reduction, patients reported “no clinically important changes in pain scores,” the study authors found. 

    Study author Dr. Joceline Vu, a surgical resident at the University of Michigan, said that controlling the number of opioids people are given after a surgery can help reduce their risk for long-term use, and can help avoid introducing people to opioids. 

    “For healthy people, surgery may be the first time they are exposed to opioids,” she told ABC News. 

    On average, Michigan physicians prescribed eight fewer opioids per patient after the guidelines were released. Patients took, on average, three fewer pain pills. The percentage of prescriptions that were for fewer pills increased from 20% to 59% during the seven months of the study. 

    Dr. Joshua Sharfstein, who has studied the opioid epidemic as a professor at Johns Hopkins Bloomberg School of Public Health, said that the study shows that changing recommendations can have a real impact on doctors’ habits. 

    “The results here are promising,” he said. “Most [physicians] prescribe by routine, and changing those routines is hard. This shows that some changes are possible. It is important that this study be read, and people realize that changes are possible.” 

    Before the statewide guidelines were issued by the Michigan Surgical Quality Collaborative, there was no standard that doctors could turn to for guidance on how many opioids to prescribe. Vu explained that doctors always wanted to be sure patients had enough pain pills, so that patients would report that they were satisfied with their surgical experience. Having lower patient satisfaction could affect ratings for doctors and hospitals, she noted. 

    However, the study found that patients did not experience increased pain levels when they were given fewer opioids. This shows that reducing the number of opioids prescribed is an effective way to mitigate the risks of opioids, without compromising patient comfort, the researchers say. 

    View the original article at thefix.com

  • Surgeons Are Still Prescribing Too Many Opioids

    Surgeons Are Still Prescribing Too Many Opioids

    Though opioid prescriptions have declined, surgeons are still prescribing more than the recommended number of pills.

    Surgeons are still prescribing far too many opioids to their patients following surgical procedures, increasing their risk of long-term opioid use or addiction. 

    According to a recent analysis by Kaiser Health News and Johns Hopkins, surgeons still prescribe many times the recommended amount of pain medications. By analyzing Medicare data, the researchers found that some patients who undergo coronary bypass and knee surgeries took home more than 100 pain pills for the first week following their operations. Thirty pills would be the maximum amount recommended by current standards, researchers noted. 

    Andrew Kolodny, director of the advocacy group Physicians for Responsible Opioid Prescribing, said, “Prescribers should have known better.” 

    The researchers looked at data from 2011 to 2016. Even though opioid prescriptions started to decline during that time, the number of pills being prescribed was well above the recommended safe levels. Dr. Chad Brummett, associate professor at the University of Michigan, said that even if the prescription amounts have continued to fall since 2016 they are likely still too high. 

    “When prescribing may have been five to 20 times too high, even a reduction that is quite meaningful still likely reflects overprescribing,” he said. 

    Members of the medical community pointed out that surgeons were taught for years to mitigate pain by using opioids, but now they are being asked to drastically change the way they manage patients’ pain. Dr. David Hasleton, senior medical director in Utah said that it can be difficult to talk to doctors about their prescribing habits. 

    “Globally, we were overprescribing by 50%,” he said Dr. David Hasleton, senior medical director. “If you go to a prescriber to say, ‘You are overprescribing,’ it never goes well. A common reaction is, ‘Your data is wrong’ or ‘My patients are different than his.’”

    In fact, that’s exactly what happened when Kaiser reached out to the top prescribers. Most didn’t comment, but some expressed surprise that they were prescribing more opioids than their colleagues. Others said that their patients are not at risk for long-term opioid use, although data shows that 6% of people who receive opioids after a surgery will go on to use them long term. 

    “I can absolutely tell you I don’t have even 1% who become long-term opioid users,” said Nebraska surgeon Janet Grange.

    Oregon surgeon Audrey Garrett, was surprised to learn that she was a top prescriber, and equally surprised to hear that 6% of patients given opioids will develop long-term use. 

    “That is a shocking number,” she said. “If it’s true, it’s something we need to educate physicians on much earlier in their medical careers.”

    View the original article at thefix.com