Category: Federal Forum Posters
Purpose: The United States is facing a public health crisis with rising death tolls from prescription opioids in the past 20 years. In response, the Veterans Health Administration has developed the six essentials elements of good pain care. This quality improvement project aims to focus on instituting evidence based medication prescribing and safe opioid use. The purpose of this study is to determine the effect of opioid prescribing following orthopedic surgery leading to prolonged use of opioid medications.
Methods: This is a retrospective chart review quality improvement project. Quality improvement projects are exempt from requiring Institutional Review Board approval. Pharmacy Leadership and the interdisciplinary Pharmacy and Therapeutics Committee approved this quality improvement project. Patients discharged from an orthopedic procedure will be reviewed from July 1, 2014 through July 1, 2018. Data will be collected on: age, gender, ethnicity, height, weight, SCr, type of procedure, naloxone administration since discharge and opioids prescribed at discharge (strength and quantity, number of opioid prescriptions at 30, 60, 90, and 180 days post discharge). Inclusion criteria include total knee or hip arthroplasty and receipt of opioid at discharge. Patients will be excluded if on chronic opioid therapy (greater than 4 opioid prescriptions within 6 months pre-op), primary care not at VA, oncology managing opioids, hospitalization in 6 months post-op, hospice or nursing facility patient, or only tramadol prescribed at discharge. The primary objective is the number of additional opioid prescriptions at 30, 60, and 90 days post-discharge. Secondary objectives include number of prescriptions at 180 days, morphine milligram equivalents (MME) prescribed at discharge, MME prescribed between discharge and 180 days, day supply prescribed at discharge , and naloxone administered within 180 days of discharge.
Results: not applicable
Conclusion: not applicable
Katelyn McDaniel– Pharmacy Resident, VA Central Iowa Health Care System, West Des Moines, IA