Original Contribution  |   July 2020
Effect of Opioid Prescribing Education for Obstetrics and Gynecology Residents in a Safety-Net Hospital
Author Notes
  • From the Departments of Obstetrics and Gynecology (Drs Evans, McCullough, and Best) and Surgery (Dr Yorkgitis) at the University of Florida College of Medicine in Jacksonville. This study was presented as an abstract at the 67th Annual Clinical and Scientific Meeting of the American College of Obstetrics and Gynecology on May 4, 2019 in Nashville, Tennessee.  
  • Financial Disclosures: None reported.  
  • Support: None reported.  
  •  *Address correspondence to Casey Evans, MD, Department of Obstetrics and Gynecology, University of Florida College of Medicine, 655 W 8th St, Jacksonville, FL 32209-6511. Email: casey.evans@jax.ufl.edu
     
Article Information
Medical Education / Obstetrics and Gynecology / Pain Management/Palliative Care / Graduate Medical Education / Opioids
Original Contribution   |   July 2020
Effect of Opioid Prescribing Education for Obstetrics and Gynecology Residents in a Safety-Net Hospital
The Journal of the American Osteopathic Association, July 2020, Vol. 120, 456-461. doi:https://doi.org/10.7556/jaoa.2020.073
The Journal of the American Osteopathic Association, July 2020, Vol. 120, 456-461. doi:https://doi.org/10.7556/jaoa.2020.073
Abstract

Context: The number of deaths due to opioid overdose has steadily increased in the United States since the early 2000s. The US opioid epidemic calls for an urgent need to evaluate physician prescribing habits.

Objective: To educate obstetrics and gynecology residents about opioid abuse, the quantity typically prescribed postoperatively, and strategies to decrease adverse outcomes.

Methods: Obstetrics and gynecology residents at an urban safety-net hospital were given a preintervention evaluation to understand their opioid prescribing patterns and use of resources like prescription drug monitoring programs and opioid risk tool. Residents then attended a didactic session reviewing rates of adverse outcomes from overprescribing, resources to reduce adverse outcomes, and the number of opioids considered appropriate postoperatively. Residents completed an immediate postintervention evaluation to reevaluate prescribing patterns.

Results: Pre- and postintervention evaluations were completed by 13 residents. In the preintervention evaluation, all participants reported that they would prescribe at least 30 opioid pills for patients after cesarean delivery, but in the postintervention evaluation, none reported that they would prescribe more than 20 opioid pills (P=<.0001). Similar but less distinct shifts can be seen in laparoscopic hysterectomy and the use of preoperative gabapentinoids (ie, gabapentin and pregabalin). Before the intervention, 7 residents (54%) reported that they currently prescribed 20 opioid pills or more for patients after laparoscopic hysterectomy, whereas after the intervention, 1 resident (7.7%) reported that he or she would prescribe more than 20 opioid pills in (P=.0382). Before the intervention, 2 residents (15.4%) reported that they would consider gabapentinoids compared with 13 residents (100%) after the intervention.

Conclusion: Focused opioid education can reduce the intended number of opioid pills prescribed in a postoperative setting. This study highlights the effect that educational curricula can have on physician prescribing patterns to help mitigate the current epidemic and help optimize stepwise multimodal analgesia to avoid overprescribing opioids.

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