A study published in JAMA Surgery examined the types of interventions that are effective for improving stewardship in opioid prescribing postsurgery.
Researchers conducted a systematic review involving studies published after 2000 through March 2018 that included interventions aimed at postsurgical opioid stewardship and evaluated outcomes. They searched the PubMed and Embase databases for studies.
They included eight studies in the review, of which three were preintervention and postintervention comparison studies, three were controlled clinical studies, one was a time-series study and one compared postintervention results with a predetermined baseline.
Researchers found interventions done at the organization level, including changes to EHR order sets and workflow, showed clear positive results. Additionally, two studies that involved developing guidelines based on patient opioid use and giving the guidelines to clinicians reported a 53 percent reduction in the quantity of opioids prescribed.
However, one study focusing on reducing the number of children who were prescribed codeine found that 5.4 percent had inadequately controlled pain.
"The studies reviewed provide evidence that clinician-mediated and organizational-level interventions are powerful tools in creating change in postsurgical opioid prescribing," study authors concluded.
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