Abstract
Purpose
Post-operative opioid prescriptions contribute to prolonged opioid misuse and abuse. Using a national hernia registry, we aimed to evaluate the effectiveness of a data-driven educational intervention on surgeon prescribing behavior.
Methods
After collecting opioid prescribing and patient consumption data from March 2019—December 2019 in inguinal and umbilical hernia repair, the Abdominal Core Health Quality Collaborative (ACHQC) Opioid Reduction Task Force presented data at a Quality Improvement (QI) Summit to educate surgeons on strategies to minimize opioid prescribing. Surgeons were asked to implement a multimodal pain management approach and were supported with educational tools created by the task force. Prescribing and consumption data after the summit, December 2019–March 2021, were then collected to assess the effectiveness of the QI effort.
Results
Registry participation before and after the QI summit increased from 52 to 91 surgeons, with an increase of 353–830 umbilical hernia patients and 976–2447 inguinal hernia patients. After the summit, high (> 10 tablets) surgeon prescribers shifted toward low (≤ 10 tablets) prescribing. Yet, patients consumed less than what was prescribed, with a significant increase in patients consuming ≤ 10 tablets before and after the summit: 79–88% in umbilical hernia (p = 0.01) and 85–94% in inguinal hernia (p < 0.001).
Conclusions
Following an educational QI summit by the ACHQC Opioid Reduction Task Force, high opioid prescribing has shifted toward low. However, patients consume less than prescribed, highlighting the importance of continuing this effort to reduce opioid prescribing.
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Acknowledgements
The authors would like to acknowledge the contributions of Dr Michael Rosen and Dr Benjamin Poulose for their guidance and support of the Opioid Task Force.
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Dr Rana Higgins is a proctor and speaker for Intuitive Surgical and a speaker for WL Gore. Dr Jeremy Warren is a board member/treasurer of the ACHQC and a Consultant for Absolutions, with no monetary payments received. He is also a speaker for Intuitive Surgical. Drs Clayton Petro, Arielle Perez and Teresa Dews, and Sharon Phillips have no conflicts of interest to disclose. Dr Michael Reinhorn is a board member of the ACHQC with no monetary payments received. He is also consultant for Heron Therapeutics.
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This manuscript does not directly involve human participants, as it is a review of data already collected in a hernia database.
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Higgins, R.M., Petro, C.C., Warren, J. et al. The opioid reduction task force: using the ACHQC Data Registry to combat an epidemic in hernia patients. Hernia 26, 855–864 (2022). https://doi.org/10.1007/s10029-021-02556-9
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DOI: https://doi.org/10.1007/s10029-021-02556-9