Hospital for Special Surgery spine surgeons develop opioid guidelines

Written by Mackenzie Garrity | February 06, 2019 | Print  |

New York City-based Hospital for Special Surgery created an opioid prescription program.

Spine surgeons, pain management physicians, anesthesiologists and nurse managers collaborated on the online mandatory program that establishes guidelines for prescribing opioids following spine surgery.

Hospital for Special Surgery implemented the program in early 2017. A study in the Journal of Neurosurgery: Spine explored how the program has affected prescription patterns.

Researchers compared opioid prescription data of 1,177 patients treated between March 1 and Nov. 1, 2016 against 1,302 patients treated between Feb. 1 and Oct. 1, 2017. In the end, researchers found a significant reduction in both the mean amount of opioid prescriptions and number of opioid pills prescribed.

Prescriptions for 81 or more pills decreased for 65.5 percent to 25.5 percent with the program.

"While we have been able to show that qualitative prescribing guidelines work to change prescriber behavior, the most practical solution to overprescribing is to define the 'minimum necessary quantity' of opioid to prescribe for the average patient after a given spine procedure," said study author Francis Lovecchio, MD. "This will prove challenging, as postoperative opioid consumption likely depends on a complex interplay of biological, psychosocial and surgery-related factors, and patient expectations. Our group and many others are working toward this end, and I look forward to finding solutions."

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