A Multifaceted Approach to Opioid Education, Prescribing, and Disposal for Patients with Breast Cancer Undergoing Surgery.

Abstract

BACKGROUND:

Standardized prescribing practices are recommended to decrease opioid abuse, however, data regarding the handling and disposal of leftover narcotics are lacking. This quality improvement project and analysis evaluated implementation of standardized prescribing, opioid education, and a narcotic disposal system.

METHODS:

This initiative was implemented over a 1-y period among patients who underwent breast surgery. The project included the following: 1) implementation of standardized prescribing, 2) voluntary and anonymous survey analysis, and 3) preoperative education regarding risks of opioids, charcoal disposal bag distribution, and follow-up survey to assess use and use of intervention.

RESULTS:

Preintervention surveys were completed by 53 patients, and 60% (n = 32) underwent lumpectomy. Narcotic prescriptions were filled by 90%; median number of pills taken was 3 (range 0-24), however 93% felt that a non-narcotic was more effective. Eighty three percentage of patients had unused pills, and 58% kept these pills in an unlocked cabinet. Postintervention surveys were completed by 66 patients, and 48% (n = 32) underwent lumpectomy. Narcotic prescriptions were filled by 88%, median number of pills taken was 4 (range 0-40), and 89% of patients had pills leftover. Sixty seven percentage of patients found the education handout useful and charcoal bag use was reported by 37% (n = 17). The median postoperative pain control satisfaction score was 4.5 (5-point Likert scale, 1 = very dissatisfied, 5 = very satisfied) on both preintervention and postintervention surveys.

CONCLUSIONS:

This study, which included standardized prescribing parameters, opioid education, and implementation of a disposal method, was found to be feasible, beneficial, and did not compromise postoperative pain control.

• Authors: Melissa Hite, Andrew Dippre, Audrey Heldreth, David Cole, Mark Lockett, Nancy Klauber-DeMore, Andrea M Abbott
• Journal: The Journal of surgical research (J Surg Res) Vol. 257 Pg. 597-604 (01 2021) ISSN: 1095-8673 [Electronic] United States
• PMID: 32932192 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Analgesics, Opioid

Topics

• Analgesics, Opioid
• Breast Neoplasms (surgery)
• Drug Prescriptions (standards)
• Feasibility Studies
• Female
• Humans
• Mastectomy, Segmental (adverse effects)
• Middle Aged
• Opioid-Related Disorders (prevention & control)
• Pain, Postoperative (etiology, prevention & control)
• Patient Education as Topic
• Quality Improvement
• Waste Management (instrumentation)