Skip to main content
Top
Published in: Hernia 3/2022

17-01-2022 | Opioids | Original Article

The opioid reduction task force: using the ACHQC Data Registry to combat an epidemic in hernia patients

Authors: R. M. Higgins, C. C. Petro, J. Warren, A. J. Perez, T. Dews, S. Phillips, M. Reinhorn

Published in: Hernia | Issue 3/2022

Login to get access

Abstract

Purpose

Post-operative opioid prescriptions contribute to prolonged opioid misuse and abuse. Using a national hernia registry, we aimed to evaluate the effectiveness of a data-driven educational intervention on surgeon prescribing behavior.

Methods

After collecting opioid prescribing and patient consumption data from March 2019—December 2019 in inguinal and umbilical hernia repair, the Abdominal Core Health Quality Collaborative (ACHQC) Opioid Reduction Task Force presented data at a Quality Improvement (QI) Summit to educate surgeons on strategies to minimize opioid prescribing. Surgeons were asked to implement a multimodal pain management approach and were supported with educational tools created by the task force. Prescribing and consumption data after the summit, December 2019–March 2021, were then collected to assess the effectiveness of the QI effort.

Results

Registry participation before and after the QI summit increased from 52 to 91 surgeons, with an increase of 353–830 umbilical hernia patients and 976–2447 inguinal hernia patients. After the summit, high (> 10 tablets) surgeon prescribers shifted toward low (≤ 10 tablets) prescribing. Yet, patients consumed less than what was prescribed, with a significant increase in patients consuming ≤ 10 tablets before and after the summit: 79–88% in umbilical hernia (p = 0.01) and 85–94% in inguinal hernia (p < 0.001).

Conclusions

Following an educational QI summit by the ACHQC Opioid Reduction Task Force, high opioid prescribing has shifted toward low. However, patients consume less than prescribed, highlighting the importance of continuing this effort to reduce opioid prescribing.
Literature
1.
go back to reference Phillips DM (2000) JCAHO pain management standards are unveiled. JAMA 284(4):428–429CrossRef Phillips DM (2000) JCAHO pain management standards are unveiled. JAMA 284(4):428–429CrossRef
2.
go back to reference American Pain Society Quality of Care Committee (1995) Quality improvement guidelines for the treatment of acute pain and cancer pain. JAMA 274(23):1874–1880CrossRef American Pain Society Quality of Care Committee (1995) Quality improvement guidelines for the treatment of acute pain and cancer pain. JAMA 274(23):1874–1880CrossRef
4.
go back to reference Baker DW (2017) History of the Joint Commission’s Pain Standards: lessons for today’s prescription opioid epidemic. JAMA 317(11):1117–1118CrossRef Baker DW (2017) History of the Joint Commission’s Pain Standards: lessons for today’s prescription opioid epidemic. JAMA 317(11):1117–1118CrossRef
6.
go back to reference Brummett CM, Waljee JF, Goesling J et al (2017) New persistent opioid use after minor and major surgical procedures in US adults. JAMA Surg 152(6):e170504CrossRef Brummett CM, Waljee JF, Goesling J et al (2017) New persistent opioid use after minor and major surgical procedures in US adults. JAMA Surg 152(6):e170504CrossRef
7.
go back to reference Finkelstein Y, Macdonald EM, Gonzalez A et al (2017) Overdose risk in young children of women prescribed opioids. Pediatrics 139:3CrossRef Finkelstein Y, Macdonald EM, Gonzalez A et al (2017) Overdose risk in young children of women prescribed opioids. Pediatrics 139:3CrossRef
8.
go back to reference Hill MV, McMahon ML, Stucke RS et al (2017) Wide variation and excessive dosage of opioid prescriptions for common general surgical procedures. Ann Surg 265(4):709–714CrossRef Hill MV, McMahon ML, Stucke RS et al (2017) Wide variation and excessive dosage of opioid prescriptions for common general surgical procedures. Ann Surg 265(4):709–714CrossRef
11.
go back to reference Thiels CA, Ubl DS, Yost KJ et al (2018) Results of a prospective, multicenter initiative aimed at developing opioid-prescribing guidelines after surgery. Ann Surg 268(3):457–468CrossRef Thiels CA, Ubl DS, Yost KJ et al (2018) Results of a prospective, multicenter initiative aimed at developing opioid-prescribing guidelines after surgery. Ann Surg 268(3):457–468CrossRef
15.
go back to reference Kaafarani HMA, Eid AI, Antonelli DM et al (2019) Description and impact of a comprehensive multispecialty multidisciplinary intervention to decrease opioid prescribing in surgery. Ann Surg 270(3):452–462CrossRef Kaafarani HMA, Eid AI, Antonelli DM et al (2019) Description and impact of a comprehensive multispecialty multidisciplinary intervention to decrease opioid prescribing in surgery. Ann Surg 270(3):452–462CrossRef
16.
go back to reference Schommer J, Allen S, Scholz N et al (2020) Evaluation of quality improvement methods for altering opioid prescribing behavior in hand surgery. J Bone Jt Surg Am 102(9):804–810CrossRef Schommer J, Allen S, Scholz N et al (2020) Evaluation of quality improvement methods for altering opioid prescribing behavior in hand surgery. J Bone Jt Surg Am 102(9):804–810CrossRef
17.
go back to reference Allan LD, Coyne C, Byrnes CM et al (2020) Tackling the opioid epidemic: reducing opioid prescribing while maintaining patient satisfaction with pain management after outpatient surgery. Am J Surg 220(4):1108–1114CrossRef Allan LD, Coyne C, Byrnes CM et al (2020) Tackling the opioid epidemic: reducing opioid prescribing while maintaining patient satisfaction with pain management after outpatient surgery. Am J Surg 220(4):1108–1114CrossRef
18.
go back to reference Warren JA, Stoddard C, Hunter AL et al (2017) Effect of multimodal analgesia on opioid use after open ventral hernia repair. J Gastrointest Surg 21(10):1692–1699CrossRef Warren JA, Stoddard C, Hunter AL et al (2017) Effect of multimodal analgesia on opioid use after open ventral hernia repair. J Gastrointest Surg 21(10):1692–1699CrossRef
19.
go back to reference Pruitt LCC, Swords DS, Vijayakumar S et al (2020) Implementation of a quality improvement initiative to decrease opioid prescribing in general surgery. J Surg Res 247:514–523CrossRef Pruitt LCC, Swords DS, Vijayakumar S et al (2020) Implementation of a quality improvement initiative to decrease opioid prescribing in general surgery. J Surg Res 247:514–523CrossRef
20.
go back to reference Coughlin JM, Shallcross ML, Schafer WLA et al (2019) Minimizing opioid prescribing in surgery (MOPiS) initiative: an analysis of implementation barriers. J Surg Res 239:309–319CrossRef Coughlin JM, Shallcross ML, Schafer WLA et al (2019) Minimizing opioid prescribing in surgery (MOPiS) initiative: an analysis of implementation barriers. J Surg Res 239:309–319CrossRef
21.
go back to reference Sceats LA, Ayakta N, Merrell SB et al (2020) Drivers, beliefs, and barriers surrounding surgical opioid prescribing: a qualitative study of surgeons’ opioid prescribing habits. J Surg Res 247:86–94CrossRef Sceats LA, Ayakta N, Merrell SB et al (2020) Drivers, beliefs, and barriers surrounding surgical opioid prescribing: a qualitative study of surgeons’ opioid prescribing habits. J Surg Res 247:86–94CrossRef
22.
go back to reference Chiu AS, Healy JM, DeWane MP et al (2018) Trainees as agents of change in the opioid epidemic: optimizing the opioid prescription practices of surgical residents. J Surg Educ 75(1):65–71CrossRef Chiu AS, Healy JM, DeWane MP et al (2018) Trainees as agents of change in the opioid epidemic: optimizing the opioid prescription practices of surgical residents. J Surg Educ 75(1):65–71CrossRef
23.
go back to reference Chiu AS, Ahle SL, Freedman-Weiss MR et al (2019) The impact of a curriculum on postoperative opioid prescribing for novice surgical trainees. Am J Surg 217(2):228–232CrossRef Chiu AS, Ahle SL, Freedman-Weiss MR et al (2019) The impact of a curriculum on postoperative opioid prescribing for novice surgical trainees. Am J Surg 217(2):228–232CrossRef
24.
go back to reference Vu JV, Howard RA, Gunaseelan V et al (2019) Statewide implementation of postoperative opioid prescribing guidelines. N Engl J Med 381(7):680–682CrossRef Vu JV, Howard RA, Gunaseelan V et al (2019) Statewide implementation of postoperative opioid prescribing guidelines. N Engl J Med 381(7):680–682CrossRef
25.
go back to reference Peterman DE, Knoedler BP, Ewing JA et al (2020) Implementation of an evidence-based protocol significantly reduces opioid prescribing after ventral hernia repair. Am Surg 86(11):1602–1606CrossRef Peterman DE, Knoedler BP, Ewing JA et al (2020) Implementation of an evidence-based protocol significantly reduces opioid prescribing after ventral hernia repair. Am Surg 86(11):1602–1606CrossRef
26.
go back to reference Millard JL, Moraney R, Childs JC et al (2020) Opioid use after inguinal and ventral hernia repair. Am Surg 86(8):965–970CrossRef Millard JL, Moraney R, Childs JC et al (2020) Opioid use after inguinal and ventral hernia repair. Am Surg 86(8):965–970CrossRef
Metadata
Title
The opioid reduction task force: using the ACHQC Data Registry to combat an epidemic in hernia patients
Authors
R. M. Higgins
C. C. Petro
J. Warren
A. J. Perez
T. Dews
S. Phillips
M. Reinhorn
Publication date
17-01-2022
Publisher
Springer Paris
Published in
Hernia / Issue 3/2022
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-021-02556-9

Other articles of this Issue 3/2022

Hernia 3/2022 Go to the issue