MP31-05 LARGE SCALE IMPLEMENTATION OF OPIOID PRESCRIPTION REDUCTION AFTER ROBOTIC PROSTATECTOMY – 2 YEAR EVALUATION FROM THE PENNSYLVANIA UROLOGIC REGIONAL COLLABORATIVE (PURC) (2022)

You have accessJournal of UrologyCME1 May 2022MP31-05 LARGE SCALE IMPLEMENTATION OF OPIOID PRESCRIPTION REDUCTION AFTER ROBOTIC PROSTATECTOMY – 2 YEAR EVALUATION FROM THE PENNSYLVANIA UROLOGIC REGIONAL COLLABORATIVE (PURC) Thenappan Chandrasekar, Necole Streeper, Charles Keith, Andrea Quin, Kaynaat Syed, Alexander Kutikov, John Danella, Thomas Lanchoney, Jeffrey Tomaszewski, Edouard Trabulsi, Adam Reese, Marc Smaldone, Robert Uzzo, Thomas Guzzo, Jay Raman, Adrien Bernstein, and Daniel Lee Thenappan ChandrasekarThenappan Chandrasekar More articles by this author , Necole StreeperNecole Streeper More articles by this author , Charles KeithCharles Keith More articles by this author , Andrea QuinAndrea Quin More articles by this author , Kaynaat SyedKaynaat Syed More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , John DanellaJohn Danella More articles by this author , Thomas LanchoneyThomas Lanchoney More articles by this author , Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , Adam ReeseAdam Reese More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Jay RamanJay Raman More articles by this author , Adrien BernsteinAdrien Bernstein More articles by this author , and Daniel LeeDaniel Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002580.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Diversion of post-operative medication is a major contributor to opioid misuse. The objective of this study is to evaluate the impact of implementing an opioid reduction protocol for robotic prostatectomy (RALP) within a regional collaborative. METHODS: An opioid reduction protocol was implemented for patients undergoing RALP at four institutions within the Pennsylvania Urologic Regional Collaborative (PURC). We compared prescribing practices 12 months before and after the intervention, with a one-month washout period. We measured opioid inpatient orders and prescriptions on discharge and patient reported pain levels at their first post-operative visit. All opioid prescriptions were converted into equivalents of oxycodone 5 mg tablets. Pain scores were captured with a visual analog scale of 0-10. RESULTS: Overall, 2,061 patients underwent RALP. For the 12 months before implementation, a median of 2.7 (IQR 1.3-4.5) oxycodone 5 mg tablets were prescribed as an inpatient, and 20 tablets were prescribed on discharge (IQR 14-30). After implementation, this decreased to a median of 2.2 (IQR 0.2-4.1) tablets as an inpatient, and median of 0 tablets (IQR 0-14, p <0.001) prescribed. The percentage of patients who had no opioid use as inpatients but were still given opioids on discharge decreased from 98% before implementation to 25% after implementation (p <0.001). Despite the decrease in opioid prescriptions, there were no significant changes in pain scores (median value 0/10, p=0.78, Figure 1). On average, 14 less opioid tablets were prescribed per RALP, leading to a total of 14,582 less opioid tablets in Pennsylvania over a 1-year period. CONCLUSIONS: Adequate pain control is feasible without opiates for the majority of patients undergoing RALP, allowing for significant reductions in the number of opioids entering the community. Policies to encourage opioid stewardship should be designed to encourage adoption of such programmatic change. Source of Funding: Data was provided with permission from the Pennsylvania Urology Regional Collaborative (PURC), funded by participating urology practices and the Partnership for Patient Care, a quality improvement initiative supported by the Health Care Improvement Foundation, Independence Blue Cross, and southeastern PA hospitals and health systems © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e523 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Thenappan Chandrasekar More articles by this author Necole Streeper More articles by this author Charles Keith More articles by this author Andrea Quin More articles by this author Kaynaat Syed More articles by this author Alexander Kutikov More articles by this author John Danella More articles by this author Thomas Lanchoney More articles by this author Jeffrey Tomaszewski More articles by this author Edouard Trabulsi More articles by this author Adam Reese More articles by this author Marc Smaldone More articles by this author Robert Uzzo More articles by this author Thomas Guzzo More articles by this author Jay Raman More articles by this author Adrien Bernstein More articles by this author Daniel Lee More articles by this author Expand All Advertisement PDF downloadLoading ...