September 12, 2019
Efforts to optimize opioid prescribing and pain treatment after surgery should consider the interacting perspectives of the patient, the perioperative team, and the pharmacist, advises a study published in the American Journal of Health-System Pharmacy.
Researchers reviewed the literature for studies addressing post-surgery opioid prescribing influences in an attempt to generate a conceptual framework to guide future efforts.
“Millions of Americans who undergo surgical procedures receive opioid prescriptions as they return home,” researchers wrote. “While some derive great benefit from these medicines, others experience adverse events, convert to chronic opioid use, or have unused medicines that serve as a reservoir for potential nonmedical use.”
In addition to identifying the patient, perioperative team, and pharmacist as the three major influencers of prescribing after surgery, the review revealed that systems-based factors also play a key role. For example, an organization’s ability to provide multimodal analgesia or enhanced recovery-after-surgery programs affect patient-pharmacist-perioperative team interactions and, ultimately, opioid-related safety outcomes.
“The severity and persistence of the opioid crisis underscore the urgent need for interventions to improve postoperative prescription opioid use in the United States,” researchers wrote. “Such interventions are likely to be most effective, with the fewest unintended consequences, if based on sound evidence and built on multidisciplinary efforts that include pharmacists, nurses, surgeons, anesthesiologists, and the patient.”
Bicket MC, Brat GA, Hutfless S, Wu CL, Nesbit SA, Alexander GC. Optimizing opioid prescribing and pain treatment for surgery: review and conceptual framework [published online September 3, 2019]. Am J Health Syst Pharm. 2019;76(18):1403-1412. doi: 10.1093/ajhp/zxz146