Clinical Pathway Effective in Reducing Discharge Opioids After Pediatric Orthopedic Surgery

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At the initiation of the opioid prescribing clinical pathway, all care team members met to create self-imposed guidelines of discharge orders.
At the initiation of the opioid prescribing clinical pathway, all care team members met to create self-imposed guidelines of discharge orders.

The following article is part of conference coverage from the PAINWeek 2018 conference in Las Vegas, Nevada. Clinical Pain Advisor's staff will be reporting breaking news associated with research conducted by leading experts in pain medicine. Check back for the latest news from PAINWeek 2018.

LAS VEGAS — A clinical pathway designed to reduce variations in opioid prescriptions for acute pain in children discharged after orthopedic surgery, was found to be effective in reducing prescriptions while maintaining analgesia, according to a retrospective review presented during the 2018 PAINWeek conference, held September 4-8.

At the initiation of the opioid prescribing clinical pathway, all care team members met to create self-imposed guidelines of discharge orders to be used when sending a pediatric patient home after orthopedic surgery, and decided on a 7-day maximum for prescribed opioids. Using these new guidelines, the hospital discharged 1375 pediatric surgery patients in 2017 (median age, 10). 

At baseline, 56.2% of discharge prescriptions followed this guideline, with a prescribed range of 0.04 to 125 days (average, 7.35 days). After implementation, 83.8% of the discharge prescriptions adhered to this guideline. This reduction was completed without compromising pain management.

Future plans include expanding protocols to other hospital departments, creating a Data Mart for collecting prescribing data, and merging Prescription Drug Monitoring Program into electronic health records.

”The pathway incorporated innovative strategies for implementing and enforcing appropriate utilization of opioids for acute pain in pediatric patients,” noted the study authors.

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Reference

Reid A, Nickels S, Mooney R, et al. Opioid prescribing practices in a pediatric hospital: next steps, opioid stewardship. Presented at: PAINWeek 201; September 4-8, 2018; Las Vegas NV. Abstract 10. WEBSITE

For more coverage of PAINWeek 2018, click here.

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