Emergency department opioid pain medication prescribing: Influence of patient satisfaction and other factors

Merriman, Matthew; Acquisto, Nicole M.; Nelson, Shakira M.; Jones, Courtney Marie Cora; Li, Timmy; McCann, Molly; Adler, David

doi:10.1016/j.ajem.2017.09.039

Cited by 9 publications

(11 citation statements)

References 14 publications

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“…13 These satisfaction metrics are important for health care center valuations but also have the ability to influence the care-providing, itself. Merriman et al 3 recently published the results of a survey sent to emergency medicine physicians and reported that 50% of physicians believe patients are more satisfied when given opioid medications in the emergency department or as a discharge prescription. Perhaps more significantly, roughly 30% of those surveyed believed that patient satisfaction survey scores are superior when given opioid medications (either in emergency department as discharge prescription).…”

Section: Discussionmentioning

confidence: 99%

“…The primary outcomes of interest in this study were the following: (1) Discharge opioid prescription quantity and (2) patient satisfaction with pain control, as determined by a Likert-type scaled response to the survey question "rate the degree to which your pain was controlled (1)(2)(3)(4)(5)." PG data were obtained from our institution's PG representative.…”

Section: Variables Of Interestmentioning

confidence: 99%

“…6 These programs place great emphasis on the patient's perception of care, and pain control remains a major metric in this paradigm. 3,4 Previous research by Kohring et al 7 demonstrated no correlation between PG scores and patient-reported outcome scores in patients undergoing total hip arthroplasty. Recently, Bloom et al 8 demonstrated that PG pain control survey scores did not decrease when…”

mentioning

confidence: 94%

“…2 Overprescription has been linked with physician desire to properly manage patient expectations, along with fear of potential consequences associated with undertreating pain. 3 Existing literature has suggested that overprescribing is linked, at least in part, to a physician desire to mitigate poor patient satisfaction ratings, despite providing otherwise positive health care. [3][4][5] The PresseGaney (PG) survey is a commonly administered patient satisfaction tool that measures patient perception of care, using similar metrics as the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which is used as a reimbursement metric by the Value-Based Purchasing program.…”

mentioning

confidence: 99%

“…3 Existing literature has suggested that overprescribing is linked, at least in part, to a physician desire to mitigate poor patient satisfaction ratings, despite providing otherwise positive health care. [3][4][5] The PresseGaney (PG) survey is a commonly administered patient satisfaction tool that measures patient perception of care, using similar metrics as the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which is used as a reimbursement metric by the Value-Based Purchasing program. 6 These programs place great emphasis on the patient's perception of care, and pain control remains a major metric in this paradigm.…”

mentioning

confidence: 99%

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Institutional Reductions in Opioid Prescribing Following Hip Arthroscopy Do Not Change Patient Satisfaction Scores

Bloom

Manjunath

Wang

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose:To investigate what effect decreased opioid prescribing following hip arthroscopy had on PresseGaney satisfaction survey scores. Methods: A retrospective review of prospectively collected data was conducted on patients who underwent primary hip arthroscopy for femoroacetabular impingement between October 2014 and October 2019. Inclusion criteria consisted of complete PresseGaney survey information, no history of trauma, fracture, connective tissue disease, developmental hip dysplasia, autoimmune disease, or previous hip arthroscopy. Groups were separated based on date of surgery relative to implementation of an institutional opioid reduction policy that occurred in October 2018. Prescriptions were converted to milligram morphine equivalents (MME) for direct comparison between different opioids. Results: A total of 113 patients met inclusion criteria, 88 preprotocol and 25 postprotocol. There were no statistically significant differences between groups with respect to patient demographics or intraoperative pathologies (P > .05). Average opioid prescription dropped from 249.6 AE 152 MME (equivalent to 33.3 tablets of oxycodone 5 mg) preprotocol to 108.6 AE 84.7 MME (equivalent to 14.5 tablets of oxycodone 5 mg) postprotocol; P ¼ .0002. There were no statistically significant differences in PresseGaney survey scores between pre-and postprotocol groups (P > .05). Conclusions: A reduction in opioids prescribed after a hip arthroscopy is not associated with any statistically significant difference in patient satisfaction with pain management, as measured by the PresseGaney survey. Level of Evidence: Level III, retrospective comparative study.T he opioid epidemic was responsible for more than 46,000 deaths in the United States in 2018. 1 While awareness and advocacy have increased tremendously, there remain many areas for improvement. Orthopaedic surgeons are the third-greatest prescribers of opioids among all specialties and therefore play a significant role in both the cause and the solution to this epidemic. 1 Opioid-based analgesia routinely has been prescribed to manage acute pain after orthopaedic procedures. 2 Overprescription has been linked with physician desire to properly manage patient expectations, along with fear of potential consequences associated with undertreating pain. 3 Existing literature has suggested that overprescribing is linked, at least in part, to a physician desire to mitigate poor patient satisfaction ratings, despite providing otherwise positive health care. [3][4][5] The PresseGaney (PG) survey is a commonly administered patient satisfaction tool that measures patient perception of care, using similar metrics as the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which is used as a reimbursement metric by the Value-Based Purchasing program. 6 These programs place great emphasis on the patient's perception of care, and pain control remains a major metric in this paradigm. 3,4 Previous research by Kohring et al. 7 demonstrated no correlation between PG scor...

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Section: Discussionmentioning

confidence: 99%

Section: Variables Of Interestmentioning

confidence: 99%

mentioning

confidence: 94%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Institutional Reductions in Opioid Prescribing Following Hip Arthroscopy Do Not Change Patient Satisfaction Scores

Bloom

Manjunath

Wang

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Association of Decreased Postsurgical Opioid Prescribing With Patients’ Satisfaction With Surgeons

2019

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IMPORTANCE Opioid overdose is the leading cause of injury-related death in the United States. Several studies have shown that surgeons overprescribe opioids, and guidelines for appropriate opioid prescribing are available. Concern about patient-reported satisfaction scores may be a barrier to surgeons adopting guideline-directed prescribing.OBJECTIVE To determine whether decreased opioid prescribing is associated with a decrease in patient-reported satisfaction with their surgeon. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of clinician satisfaction scores at Dartmouth-Hitchcock Medical Center obtained in 2 periods: 1 before (period A) and 1 after (period B) an educational intervention that resulted in decreased opioid prescribing. The analysis included 11 surgeons who performed 5 common outpatient general surgical operations on 996 patients. Data were analyzed between March and August 2018. MAIN OUTCOMES AND MEASURESPatient-reported overall satisfaction rating of the surgeon (scale, 0-10). This was collected by a nonstudy-related, routine general institutional survey of approximately 40% of all outpatient encounters. RESULTSOf the total number of patients, 67% were women (667 of 996), and the mean patient age was 58 years. Comparing period A with B, the proportion of patients prescribed opioids decreased from 90.2% (n = 367 of 407) to 72.8% (n = 429 of 589) (P < .001). The mean number of opioid pills per prescription decreased from 28.3 to 13.3 (P < .001) and significantly decreased for each of the 11 surgeons. One hundred five of 996 patients (10.5%) undergoing index operations responded to the survey. There was no difference in the mean clinician satisfaction ratings from period A vs B (9.70 vs 9.65; P = .69). During the study periods, 640 total surveys were collected referencing these surgeons (including outpatient encounters associated with operations other than the 5 index cases). There was no difference in the mean satisfaction ratings from period A vs period B (9.55 vs 9.59; P = .62). When individual clinicians were analyzed, none had a significant difference in overall satisfaction rating from period A vs period B.CONCLUSIONS AND RELEVANCE Despite a marked decrease in the proportion of patients receiving opioids and in the number of pills prescribed, there was no significant change in clinician satisfaction ratings.

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Patient Satisfaction After Total Hip Arthroplasty Is Not Influenced by Reductions in Opioid Prescribing

Bloom¹,

Manjunath²,

Gualtieri³

et al. 2021

The Journal of Arthroplasty

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Emergency department opioid pain medication prescribing: Influence of patient satisfaction and other factors

Cited by 9 publications

References 14 publications

Institutional Reductions in Opioid Prescribing Following Hip Arthroscopy Do Not Change Patient Satisfaction Scores

Institutional Reductions in Opioid Prescribing Following Hip Arthroscopy Do Not Change Patient Satisfaction Scores

Association of Decreased Postsurgical Opioid Prescribing With Patients’ Satisfaction With Surgeons

Patient Satisfaction After Total Hip Arthroplasty Is Not Influenced by Reductions in Opioid Prescribing

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