Survey: Residents Often Over-Prescribe Post-Surgical Opioids

Senior medical residents appear to prescribe higher doses of post-surgical opioids, according to research presented at AAGL Virtual 2020.

“Opioid over-prescription in surgical patients has been described as a leading contributor to the opioid epidemic. At academic centers, the discharge prescription is often written by the resident. The objective of this study is to identify the prescribing practices of gynecology residents to manage post-operative pain,” the researcher wrote.

They conducted a cross-sectional survey of gynecology residents enrolled in postgraduate years 1 through 5 at a Canadian OBGYN residency. Overall, 100% of year-1 residents and 53% of year-5 residents reported formal training on pain management. The average morphine milligram equivalents (MME) prescribed following total laparoscopic hysterectomy (TLH) was 37.5, compared with 68.5 for total abdominal hysterectomy (TAH). Year-1 residents prescribed an average MME of 18 for TLH, while year-5 residents prescribed an average of 43 MME. Among the participants, 46% reported rarely or never counselling patients on safe opioid disposal.

“Senior residents appear to prescribe higher MME and have lower rates of pain management education. Targeted resident education and interventions focused on shared decision making between patients and providers could reduce MME prescriptions. Trainees would benefit from education on non-opioid alternative therapies and safe opioid disposal.

—Michael Potts

Reference:

Sidana N, Liu GY, Po L. “Addressing the opioid epidemic at the front lines”: surveying opioid prescribing practices of OBGYN residents across Canada. Presented at AAGL Virtual 2020. November 6-14. Virtual. https://aagl.confex.com/aagl/2020/meetingapp.cgi/Paper/4679