Association of caregiver-reported education with locked storage and disposal of prescription opioids after children's surgery

Sloss, Kenneth R.; Vargas, Gracia; Brummett, Chad M.; Englesbe, Michael J.; Waljee, Jennifer F.; Gadepalli, Samir K.; Harbaugh, Calista M.

doi:10.1016/j.jpedsurg.2020.04.022

Cited by 12 publications

(11 citation statements)

References 22 publications

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“…The substantial quantity of unused pills observed in our study (70% of prescribed pills) is consistent with other published reports 14,17,39–45 . Although there is agreement about the need for disposal of unused pills, the optimal method is uncertain 21,46 . Published interventions have focused on patient education, 18–24 provision of drug disposal kits, 25–32,47 and take‐back programs 33–35 .…”

Section: Discussionsupporting

confidence: 88%

“…Interventions to enhance disposal of unused pills have focused on patient education,, 18–24 provision of drug disposal kits, 25–32 and take‐back programs 33–35 . These endeavors have shown mixed results in trials and are likely insufficient in isolation.…”

Section: Introductionmentioning

confidence: 99%

“…16 Yet, although 70% of prescribed opioids go unused after surgery, less than 10% are disposed of properly. 17 Interventions to enhance disposal of unused pills have focused on patient education,, [18][19][20][21][22][23][24] provision of drug disposal kits, [25][26][27][28][29][30][31][32] and take-back programs. [33][34][35] These endeavors have shown mixed results in trials and are likely insufficient in isolation.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of a password‐protected, pill‐dispensing device with mail return capacity to enhance disposal of unused opioids after cancer surgery

Cogan

Accordino

Beauchemin

et al. 2022

Cancer

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Background Opioid misuse is a public health crisis, and unused postoperative opioids are an important source. Although 70% of pills prescribed go unused, only 9% are discarded. This study evaluated whether an inexpensive pill‐dispensing device with mail return capacity could enhance disposal of unused opioids after cancer surgery. Methods A prospective pilot study was conducted among adult patients who underwent major cancer‐related surgery. Patients received opioid prescriptions in a mechanical device (Addinex) linked to a smartphone application (app). The app provided passwords on a prescriber‐defined schedule. Patients could enter a password into the device and receive a pill if the prescribed time had elapsed. Patients were instructed to return the device and any unused pills in a disposal mailer. The primary end point was feasibility of device return, defined as ≥50% of patients returning the device within 6 weeks of surgery. Also explored was total pill use and return as well as patient satisfaction. Results Among 30 patients enrolled, the majority (n = 24, 80%) returned the device, and 17 (57%) returned it within 6 weeks of surgery. In total, 567 opioid pills were prescribed and 170 (30%) were used. Of 397 excess pills, 332 (84% of unused pills, 59% of all pills prescribed) were disposed of by mail. Among 19 patients who obtained opioids from the device, most (n = 14, 74%) felt the benefits of the device justified the added steps involved. Conclusions Use of an inexpensive pill‐dispensing device with mail return capacity is a feasible strategy to enhance disposal of unused postoperative opioids.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of a password‐protected, pill‐dispensing device with mail return capacity to enhance disposal of unused opioids after cancer surgery

Cogan

Accordino

Beauchemin

et al. 2022

Cancer

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“…Among U.S. adults reporting opioid misuse or opioid use disorder in 2015, 36% obtained the opioids for their most recent misuse from their own prescription, and 47% from a friend or relative's prescription. 20 This brings into focus the need for strategies such as storage education 42 and home disposal kits 43 to decrease opioid diversion.…”

Section: Excess Opioid Prescribingmentioning

confidence: 99%

Perioperative Opioids, the Opioid Crisis, and the Anesthesiologist

2022

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“…74 It is clear that current efforts to decrease adult opioid use have not diminished opioid exposure to children. 66,73,75 The combination of outpatient opioid overprescribing, large amounts of unused opioids, retention for future use, and storage in unsecured accessible locations creates a vast risk space of hundreds of millions of opioid pills, 76 and opportunity for potential harm. This constitutes the opioid pool.…”

Section: Postoperative Pain and Opioids: The Problem Of Variabilitymentioning

confidence: 99%

Opioids and Public Health: The Prescription Opioid Ecosystem and Need for Improved Management

2021

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While U.S. opioid prescribing has decreased 38% in the past decade, opioid deaths have increased 300%. This opioid paradox is poorly recognized. Current approaches to opioid management are not working, and new approaches are needed. This article reviews the outcomes and shortcomings of recent U.S. opioid policies and strategies that focus primarily or exclusively on reducing or eliminating opioid prescribing. It introduces concepts of a prescription opioid ecosystem and opioid pool, and it discusses how the pool can be influenced by supply-side, demand-side, and opioid returns factors. It illuminates pressing policy needs for an opioid ecosystem that enables proper opioid stewardship, identifies associated responsibilities, and emphasizes the necessity of making opioid returns as easy and common as opioid prescribing, in order to minimize the size of the opioid pool available for potential diversion, misuse, overdose, and death. Approaches are applicable to opioid prescribing in general, and to opioid prescribing after surgery.

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Association of caregiver-reported education with locked storage and disposal of prescription opioids after children's surgery

Cited by 12 publications

References 22 publications

Efficacy of a password‐protected, pill‐dispensing device with mail return capacity to enhance disposal of unused opioids after cancer surgery

Efficacy of a password‐protected, pill‐dispensing device with mail return capacity to enhance disposal of unused opioids after cancer surgery

Perioperative Opioids, the Opioid Crisis, and the Anesthesiologist

Opioids and Public Health: The Prescription Opioid Ecosystem and Need for Improved Management

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