Postop opioid prescribing, use drop after state imposed regulations

Editor's Note

A state-mandated policy restricting opioid prescriptions in Vermont greatly reduced opioid prescribing and use by surgical patients at the University of Vermont Medical Center without affecting patient satisfaction with their postoperative pain management, finds this study presented October 29 at the American College of Surgeons Clinical Congress 2019 in San Francisco.

Comparing prescribing pattern for 15 surgical procedures during 12 months before and 17 months after the regulations went into effect, the researchers found that the median morphine milligram equivalents (MME) declined by 33%.

Prescription refill rates were 5.5% before the mandated policy change and 6.3% after, and similarly, the proportion of patients reporting an inadequate amount of medication were 11.0% before and 12.3% after--neither of the differences were statistically significant.

Patient education about nonopioid analgesia increased from 82% to 98% during the study period as did instructions on opioid disposal (19% to 52%).

Since implementing the new state regulations, there is a clear trend that physicians are prescribing fewer opioids, patients are using less, and there is no appreciable change in patient-rated satisfaction and pain control, the authors say.