Abstract
OBJECTIVE
To evaluate existing practice patterns and potential barriers to implementing opioid
stewardship protocols after robot-assisted prostatectomies among providers in the
Pennsylvania Urology Regional Collaborative.
METHODS
The Pennsylvania Urology Regional Collaborative (PURC) is a voluntary quality improvement
initiative of 11 academic and community urology practices in Pennsylvania and New
Jersey representing 97 urologists. PURC distributed a web-based survey of 24 questions,
with 74 respondents, including 56 attendings, 11 residents, and 7 advanced practice
providers.
RESULTS
More pills were prescribed if there was a default number of pills from the electronic
health record (median 30) then if the number of pills was manually placed (P = .01). Only 8% discussed how to dispose of opioids with their patients, and less
than a third of respondents discussed postoperative pain expectations or risks of
opioid use. Patient level risk factors were often not reviewed, as 42% did not ask
about previous opioid exposure.
CONCLUSION
This study revealed extensive knowledge disparities among providers about opioid stewardship
and significant gaps in the evidence-to-practice continuum of care. In the next year,
PURC will be implementing targeted interventions to augment provider education, establish
clear pathways for opioid disposal, improve utilization of known resources and implement
opioid reduction protocols in all participating sites.
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Article info
Publication history
Published online: July 22, 2020
Accepted:
May 28,
2020
Received:
January 28,
2020
Footnotes
Financial Support: This project was supported by grant number K12HS026372 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
