Physicians can effectively manage patients' pain using fewer pills without compromising patient comfort or satisfaction, according to Ann Arbor-based University of Michigan Associate Professor Chad Brummett, MD.
Dr. Brummett, who directs pain research and clinical anesthesia research efforts for the university's anesthesiology department, discussed opioid prescribing during a webinar sponsored by the AMA Organized Medical Staff Section.
Here are five takeaways:
1. Dartmouth researchers who studied patients undergoing five common outpatient procedures found wide variance in opioid prescriptions for postoperative pain. They discovered 70 percent of pills prescribed were never used.
2. A June 2017 study by University of Michigan researchers found no association between the refill rate for prescriptions and the size or strength of the original prescription.
3. According to a research letter Dr. Brummett and his colleagues wrote, opioid prescribing after surgery was not correlated with scoring on a Hospital Consumer Assessment of Healthcare Providers and Systems pain measures.
4. Dr. Brummett and his colleagues developed prescribing guidelines for postoperative laparoscopic gall bladder removal. The guidelines recommend lowering the median total oral morphine milligram equivalent of prescriptions from 250 MME to 75 MME.
5. He and his colleagues collected data suggesting persistent opioid use was influenced by several factors in addition to surgical pain, including tobacco use, alcohol and substance-use disorders, anxiety, mood disorders, preoperative back and neck pain and arthritis.