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- W2997502539 abstract "The national epidemic of opioid abuse has focused attention on postpartum analgesic utilization. Interventions that decrease inpatient opioid use after delivery could reduce the potential for prescribed opioids to serve as a gateway to chronic dependence. We aimed to evaluate the effect of removing as needed opioid medications from postpartum order sets on medication utilization following vaginal delivery. We performed a retrospective cohort study of women undergoing a singleton vaginal delivery at an academic tertiary care center. Our institution removed opioid medications from postpartum order sets in April 2018. We compared two delivery cohorts: “Pre-Intervention” (April-August, 2016) and “Post-Intervention” (June-July, 2018). We excluded deliveries from April-May 2018 to allow for change in practice. Primary outcome was any postpartum opioid use. Secondary outcomes were non-opioid analgesic use and discharge with an opioid prescription. We compared demographic, obstetric data, and postpartum analgesic utilization between groups. Opioid medications included oxycodone, hydrocodone, morphine, dilaudid, or tramadol. We determined a minimum of 138 patients were needed in each group to identify a 20% decrease in opioid usage (α = .05, β = .2). P < .05 considered significant. We analyzed 297 randomly selected subjects; 152 pre- and 145 post-intervention. The post-intervention group was older and more likely to have an operative vaginal delivery. Otherwise, groups had similar demographic and obstetric characteristics, p >.05 for all. We observed a 38% reduction in postpartum opioid use (53 to 15%, p < .001), and a simultaneous increase in non-opioid analgesic utilization (84 to 93% for ibuprofen, 20 to 35% for acetaminophen, p< .001 for all). The number of patients discharged with an opioid prescription decreased from 26 to 2%, p < .001. Removal of opioids from the postpartum order set significantly decreased opioid use following vaginal delivery in a single center. This simple intervention has the potential to reduce opioid exposure in a population vulnerable to misuse.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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- W2997502539 date "2020-01-01" @default.
- W2997502539 modified "2023-10-18" @default.
- W2997502539 title "272: Reduction of opioid utilization after vaginal delivery with an electronic health record intervention" @default.
- W2997502539 doi "https://doi.org/10.1016/j.ajog.2019.11.288" @default.
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