Four out of five opioid prescriptions written after surgery from 2013 to 2015 at Rochester, Minn.-based Mayo Clinic exceed opioid prescribing draft guidelines developed by the Minnesota Department of Human Services, according to an internal Mayo study published in the Annals of Surgery.
To assess opioid prescribing practices across Mayo's campuses, researchers with the health system examined 7,181 opioid prescriptions administered after five common surgeries from January 2013 to December 2015 at Mayo's locations in Rochester, Phoenix and Jacksonville, Fla.
Among the 5,756 surgical patients who had not used opioids 90 days prior to surgery, the median opioid prescription after surgery was equivalent to 50 pills of five-milligram oxycodone. This figure is nearly double the recommended maximum prescription established by Minnesota draft guidelines, which amounts to a seven-day course of five-milligram oxycodone, or 27 pills. Additionally, the median prescription varied across the three campuses with 40 pills at the Minnesota campus, 50 pills at the Arizona campus and 60 pills at the Florida campus.
"In light of the opioid epidemic, physicians across the country know overprescribing is a problem, and they know there is an opportunity to improve," said Elizabeth Habermann, PhD, scientific director of surgical outcomes research in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery in Rochester and the study's senior author. "This is the first step in determining what is optimal for certain surgeries and, eventually, the individual patient."
While the study does show room for improvement in opioid prescribing practices at Mayo, researchers determined the draft guidelines established by the Minnesota DHS are likely inappropriate in some cases.
"For some of the procedures, the guideline is probably appropriate, and we have an opportunity to reduce the amount prescribed," said Dr. Habermann. "For some of the more painful procedures, in orthopedics, for example, the draft guideline is likely too low."
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