For a study, the researchers sought to compare consensus recommendations for 5 surgical procedures to patient consumption statistics gathered prospectively. They pooled data from several hospitals around the country to address local variation. Between 3/2017 and 12/2018, prospective observational studies of surgical patients were completed. Investigators used post-discharge surveys and chart reviews to collect data from 5 hospitals (representing 3 hospital systems) in 5 states across the United States. They compared the prospectively obtained aggregated data to prescribing recommendations for 5 standard surgical procedures found in 2 recent consensus studies. Laparoscopic cholecystectomy, open inguinal hernia repair, laparoscopic inguinal hernia repair, partial mastectomy with sentinel lymph node biopsy, and partial mastectomy without sentinel lymph node biopsy were performed. After discharge, 847 opioid-naive patients who underwent 1 of the 5 procedures evaluated reported a count of unused opioid pills. About 41% did not take any opioid drugs, and the median oxycodone tablet usage was 3 5 mg or less across all procedures. In general, consensus reports suggested opioid doses more than the 75th percentile of intake, with recommendations exceeding the 90th percentile of consumption for 2 operations. Even though consensus recommendations were a crucial first step in addressing opioid prescribing, the research suggests that 47% to 56% of pills prescribed would go unused if study group followed recommendations. The goal of future multi-institutional efforts should be to fine-tune and personalize prescribing recommendations.
