A new study from the University of Rochester Medical Center found that simple changes in how doctors prescribe pain medication can dramatically reduce opioid use after surgery.
Researchers reported a 67 percent reduction in opioid prescriptions given to patients after surgery, without increasing patient concerns about pain.
The study followed 6,619 adult patients undergoing one of 15 elective procedures across several surgical divisions at URMC. Researchers focused on patients who had not previously used opioids.
Instead of relying on standard prescription amounts, clinicians used a team-based strategy that emphasized communication with patients and better tracking of prescribing patterns.
“Our goal was to achieve a 20 percent reduction in opioid prescription at discharge, but the strategies we deployed actually reduced it by 67 percent,” said Dr. Jacob Moalem, an endocrine surgeon at URMC and the study’s lead author. “They did so without any increase in patient-reported concern about pain.”
The findings were published in the Journal of the American College of Surgeons.
Researchers said opioid overprescribing after surgery remains common across the United States, leaving large quantities of unused medication that can be misused.
The URMC program introduced several low-cost changes to prescribing practices. These included educational materials for patients and staff, electronic medical record updates, and dashboards that tracked opioid prescribing across surgical departments.
Doctors also received quick-reference guides showing recommended prescription amounts for common operations.
The changes produced significant results. Seventy percent of patients were discharged with no opioid prescription at all, and those who did receive medication were prescribed an average of eight fewer pills.
Researchers also found patients were more than three times as likely to leave the hospital without opioids and were less likely to need refills after discharge.
Moalem said the key to the program was shifting expectations among both clinicians and patients.
“The culture change was the secret ingredient here,” he said. “We empowered the care team with all the information they needed to make an informed decision on a prescription that matched the patient’s needs.”
Researchers say the program is designed to be easily replicated because the interventions are inexpensive and simple to implement. Several other surgical departments at URMC have already adopted the approach.
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