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• W4226267036 abstract "You have accessJournal of UrologyCME1 May 2022MP31-04 PASSIVE OPIOID STEWARDSHIP INITIATIVES ASSOCIATED WITH SIGNIFICANT CHANGE IN OPIOID PRESCRIBING FOLLOWING UROLOGIC SURGERY Tudor Borza, Emily Serrell, Manasa Venkatesh, Jeremy Goodman, Elise Lawson, Sudha Quamme, Kyle Richards, David Jarrard, Caprice Greenberg, Corrine Voils, and Jessica Schumacher Tudor BorzaTudor Borza More articles by this author , Emily SerrellEmily Serrell More articles by this author , Manasa VenkateshManasa Venkatesh More articles by this author , Jeremy GoodmanJeremy Goodman More articles by this author , Elise LawsonElise Lawson More articles by this author , Sudha QuammeSudha Quamme More articles by this author , Kyle RichardsKyle Richards More articles by this author , David JarrardDavid Jarrard More articles by this author , Caprice GreenbergCaprice Greenberg More articles by this author , Corrine VoilsCorrine Voils More articles by this author , and Jessica SchumacherJessica Schumacher More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002580.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Post-operative overprescribing contributes to the opioid epidemic by (i) leading to persistent use and (ii) increasing the supply of opioids available for non-medical use. We evaluate the impact since 2017 of passive stewardship initiatives, where no direct urologist engagement occurred (e.g., Prescription Drug Monitoring Plan (PDMP), continuing medical education, new guidelines), on statewide prescribing patterns following common urologic procedures. METHODS: We used Wisconsin (WI) Health Information Organization data, an all-payer claims database covering 75% of WI population, to identify patients undergoing office (vasectomy), stone (ureteroscopy, ESWL), endoscopic (TURP, TURBT) and major (prostatectomy, nephrectomy) surgery in the one-year period prior to June 30, 2018 and 2020. We captured filled opioid prescriptions within 14 days of discharge and identified dose (median morphine milligram equivalents, MME) and duration (median days) for the initial prescription. We compared prescribing between 2018 and 2020 to assess for change in practice patterns. RESULTS: We identified 4,234 patients (1238 vasectomy, 1143 ureteroscopy, 361 ESWL, 432 TURP, 550 TURBT, 292 prostatectomy, 218 nephrectomy) in 2018 and 5,095 patients (1542 vasectomy, 1575 ureteroscopy, 394 ESWL, 482 TURP, 518 TURBT, 357 prostatectomy, 227 nephrectomy) in 2020. Overall, 40.2% and 26.9% (p <0.0001) of patients filled an opioid prescription. Of patients with an opioid fill, median MME was 100 (IQR 75-180) and 90 (IQR 60-150) in 2018 and 2020, respectively (p <0.0001). Largest decrease in patient fills occurred after vasectomy followed by stone, endoscopic and major procedures (25.2, 10.5, 9.0, 4.7 percentage points, respectively; Figure 1A). For filled prescriptions, the MME and number of tablets prescribed exceeded recommended levels for all procedures by 50 to >100% (Figure 1B). CONCLUSIONS: Passive stewardship initiatives in WI led to significant decrease in opioid prescribing. This was driven by decreased fill rates, which captured a combination of decreased prescribing and patients choosing not to fill. Despite the decrease, prescribing remains above recommended levels. Active interventions focused on direct urologist engagement may lead to further improvement in opioid stewardship. Source of Funding: n/a © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e522 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tudor Borza More articles by this author Emily Serrell More articles by this author Manasa Venkatesh More articles by this author Jeremy Goodman More articles by this author Elise Lawson More articles by this author Sudha Quamme More articles by this author Kyle Richards More articles by this author David Jarrard More articles by this author Caprice Greenberg More articles by this author Corrine Voils More articles by this author Jessica Schumacher More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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• W4226267036 title "MP31-04 PASSIVE OPIOID STEWARDSHIP INITIATIVES ASSOCIATED WITH SIGNIFICANT CHANGE IN OPIOID PRESCRIBING FOLLOWING UROLOGIC SURGERY" @default.
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