Year: 2019
Type: article
Abstract: You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making I (MP33)1 Apr 2019MP33-04 PRESCRIBING TRENDS IN POST-OPERATIVE PAIN MANAGEMENT AFTER UROLOGIC SURGERY Jeffrey L. Ellis*, Matthew Nitti, Eric Ghiraldi, Karthik Devarajan, Justin I. Friedlander, Serge Ginzburg, Steve Sterious, Joshua A. Cohn, Erin Ohmann, Philip Abbosh, Robert Uzzo, and Jay Simhan Jeffrey L. Ellis*Jeffrey L. Ellis* More articles by this author , Matthew NittiMatthew Nitti More articles by this author , Eric GhiraldiEric Ghiraldi More articles by this author , Karthik DevarajanKarthik Devarajan More articles by this author , Justin I. FriedlanderJustin I. Friedlander More articles by this author , Serge GinzburgSerge Ginzburg More articles by this author , Steve SteriousSteve Sterious More articles by this author , Joshua A. CohnJoshua A. Cohn More articles by this author , Erin OhmannErin Ohmann More articles by this author , Philip AbboshPhilip Abbosh More articles by this author , Robert UzzoRobert Uzzo More articles by this author , and Jay SimhanJay Simhan More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555869.83008.50AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: The opioid epidemic is a public health threat in the United States. Although there have been numerous studies to suggest the deleterious long term effect of overprescribing opioids in the acute postoperative period, no series have rigorously assessed prescribing patterns in urologic surgery patients following discharge. Here, we assess prescribing and refilling trends of opioid narcotics in those undergoing urologic surgery at our institution METHODS: We reviewed all urologic operative cases at our academic medical center from May 2017-April 2018. Demographic data, comorbidities, and perioperative pain management strategies were recorded and analyzed. All narcotics utilized following surgery were tabulated and reported in total morphine equivalents (TME, mg). Upon discharge from the hospital, patients were instructed to contact the Urology office for any postoperative issue following discharge, including persistent postoperative pain. A mandatory statewide narcotics utilization registry was queried for each patient to assess postoperative narcotics prescriptions along with refill data. Logistic regression analyses assessed independent predictors of those at risk of obtaining a narcotic refill following urologic surgery. RESULTS: Of 820 cases (median age 59, median discharge TME 30mg), 30.1% (median age 56, IQR 45-66) of the cohort required a narcotic refill following discharge (median TME 32 mg, IQR 20-59 mg). Urologists (U) were responsible for 47% of refills while primary care physicians (PCPs) were responsible for 37% despite all patients being actively followed by their surgeon. Procedure types with the highest rates of post-operative refills were male reconstruction/trauma (32%, MRT) followed by neurourology/female reconstruction (29%, NFR)(Figure 1). Patients were more likely to have a narcotic prescription refilled if they had diabetes (OR 1.48, p=0.02), a history of tobacco use (OR 1.48, p=0.01), or a history of illicit drug use (OR 1.61, p=0.02). CONCLUSIONS: Many postoperative urology patients receive prescription refills from their PCPs, often unbeknownst to their prescribing surgeon. Although managing appropriate patient expectations regarding postoperative pain is gaining traction, creative methods to track opioid prescriptions might be necessary in an effort to combat the opioid crisis. Source of Funding: None Philadelphia, PA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e453-e454 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeffrey L. Ellis* More articles by this author Matthew Nitti More articles by this author Eric Ghiraldi More articles by this author Karthik Devarajan More articles by this author Justin I. Friedlander More articles by this author Serge Ginzburg More articles by this author Steve Sterious More articles by this author Joshua A. Cohn More articles by this author Erin Ohmann More articles by this author Philip Abbosh More articles by this author Robert Uzzo More articles by this author Jay Simhan More articles by this author Expand All Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2941272647