Comparison of postop opioids prescribed by APCs vs surgeons

Editor's Note

This study from the University of Michigan Medical School, Ann Arbor, finds that postoperative opioid prescriptions written by advanced practice clinicians (APCs), defined as nurse practitioners and physician assistants, had higher total dosages compared with those written by surgeons.

A total of 628,197 surgical procedures involving 581,387 adults and children were analyzed. Overall, APCs wrote 19% of postoperative opioid prescriptions and 25.1% of refill prescriptions.

Prescriptions written by APCs had higher total dosages than those written by surgeons (adjusted difference, 40.0 MMEs [morphine milligram equivalents]. This difference persisted in a subgroup of opioid-naïve patients (adjusted difference, 15.7 MMEs).

The authors conclude that higher total dosages of postoperative opioid prescriptions from APCs suggest that opioid stewardship initiatives focused on these clinicians may be warranted.