Clinical Scorecard: Tracking Opioid Refills After Surgery
At a Glance
| Category | Detail |
|---|---|
| Condition | Postoperative opioid management |
| Key Mechanisms | Mismatch between discharge opioid daily doses and inpatient opioid use increases refill risk. |
| Target Population | Adult patients undergoing inpatient otolaryngology–head and neck surgery. |
| Care Setting | Academic medical center |
Key Highlights
- 25.3% of patients received an opioid refill within 30 days of discharge.
- Discharge opioid underprescription and overprescription both associated with higher refill risk.
- Preoperative opioid, benzodiazepine, and cannabis use linked to increased refill rates.
- Higher postoperative pain scores correlated with refills within 30 days.
- Receipt of a prior refill was the strongest predictor of subsequent refills.
Guideline-Based Recommendations
Diagnosis
- Assess discharge opioid prescribing patterns as matched, overprescribed, or underprescribed.
Management
- Align discharge opioid prescriptions with inpatient opioid consumption to reduce refills.
Monitoring & Follow-up
- Track opioid refill rates at 1-30, 31-60, and 61-90 days postdischarge.
Risks
- Consider preoperative medication use and postoperative pain scores as risk factors for refills.
Patient & Prescribing Data
Adult patients with a postoperative stay of at least 24 hours.
Standardize discharge opioid doses to oral morphine equivalents based on inpatient use.
Clinical Best Practices
- Evaluate and adjust discharge opioid prescriptions based on individual patient needs.
- Monitor patients with a history of opioid use closely for refill needs.
- Educate patients on the importance of adhering to prescribed opioid regimens.
Related Resources & Content
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